Total intracorporeal robotic radical hysterectomy with vaginal cerclage without uterine manipulator: A nerve sparing tumor containment technique

Abstract

This surgical film describes the steps of a novel minimally invasive surgical technique for the treatment of early-stage cervical cancer that prioritizes tumor containment and minimizes tumor seeding. Total Intracorporeal Robotic Radical Hysterectomy with Vaginal Cerclage and without uterine manipulator (TIRRHVC) is a C1 nerve sparing procedure that minimizes tumor seeding by eliminating the use of a uterine manipulator and maximizes tumor containment by placing circumferential sutures distal to the tumor, completely occluding it from the vagina. This surgical film demonstrates the relevant anatomy, dissection techniques and unique steps to accomplish a TIRRHVC, including the use of the robotic third arm for optimal traction and vaginal cerclage for complete circumferential occlusion of the cervical tumor.

Keywords

• Tumor containment
• Robotic radical hysterectomy
• Minimally invasive surgery
• Vaginal cerclage
• Cervical cancer
• Nerve sparing radical hysterectomy