Laparoscopically assisted radical vaginal hysterectomy

A vaginal or a laparoscopic approach in radical surgery for cervical carcinoma has been proposed. A pilot study of eight cases shows that an oncologic surgeon familiarized with these techniques is able to take advantage of the benefits of both routes in the same patient: laparoscopic surgery is adapted to lymph node dissection, section of the origin of the uterine artery, and dissection of the ureter under direct vision; vaginal surgery allows a precise incision of the vaginal cuff. Both routes may be used for the section of parameters, but we propose the use of the vaginal route. The combination of vaginal and laparoscopic surgery spares the pain and discomfort of both laparotomy and perineotomy.