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Abstract
Type III radical abdominal hysterectomy (RAH) is standard care for early stage cervical cancer. For the past few decades, there has been a remarkable shift from surgery to radiation, in the treatment choice for stage 1b2 and 2b cervical cancer in Japan. It is still controversial, however because some of those cases recommended RAH as a suitable treatment strategy. About 8% to 10% of RAH are abandoned because of tumor status. Recent preoperative screening cannot always detect them preoperatively. Various kinds of new surgical instruments, such as bipolar scissors and the electro vessel sealing system LigaSure have contributed to reducing the operation time and blood loss, in performing RAH. Furthermore, various kinds of devices are on the market. Surgeons should choose suitable instruments depending on the state of the disease and the patient.
References
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Fig. 1.
LigaSure Impact. (A) LigaSure Impact has light angled jaw and scissors, useful for large vessls and pelvic floors. (B) Suspensorium ovary is clamped by LigaSure Impact.
Fig. 2.
LigaSure Small Jaw. (A) LigaSure Small Jaw has similar function with LigaSure Impact, also it has suitable size for narrow pelvic space. (B) Transection of cardinal ligament by LigaSure Small Jaw.
Table 1.
Treatment strategy for stage 1b–2b cervical cancer in Japan (1999) (From JSOG tumor committee report [5])
Table 2.
Treatment strategy for stage 1b–2b cervical cancer in Japan (2009) (From Japanese Society of Gynecologist and Obstetrician tumor committee report [10])
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