Introduction/Background The aim of this study is to evaluate surgical data and oncological outcome of laparoscopic nerve-sparing radical hysterectomy without uterine manipulator for cervical cancer stage IB, over the last 11 years.

Methodology This retrospective study includes 44 patients with cervical cancer Figo stage (2009) IB who underwent laparoscopic nerve-sparing radical hysterectomy without using any kind of uterine manipulator. Patients were eligible if they had squamous cell carcinoma, adenocarcinoma, or adeno-squamous carcinoma, and no para-aortic lymph node involvement by imaging or after frozen section.

Results In the study, 44 patients were included and among them 35 women were stage IB1 (23 cases with tumor size 2–4 cm) and 8 women stage IB2 (Figo stage 2009). The median age of patients was 47.7 years (31–69) and median body mass index (B.M.I) was 26.7 kg/m2 (range 19–34.3 kg/m2). The average operating time was 221 min (146–310 min) and median hospital stay was 2.6 days (range 2–7 days). Approximate blood loss was 181 ml (120–300 ml). After a median follow-up of 54 months, we had 2 recurrences out of 44 cases and no death. Especially for patients with Figo stage (2009) IB1, the recurrence rate was 3.1%. The 3-year PFS was 95.7% and especially for the IB1 stage (2009) women, the 3-year PFS was 96.1%. The 3-year OS was 100%.

Conclusion Laparoscopic nerve-sparing radical hysterectomy without uterine manipulator is feasible and safe surgical procedure for cervical cancer with acceptable surgical and oncological outcomes in the hands of well-trained and experienced laparoscopic surgeons. Our retrospective study reveals better oncological outcome compared to other studies on the minimally invasive approach, where uterine manipulator was routinely used and no vaginal sealing of the tumor was made.