Introduction The video is about **single port radical hysterectomy with total mesometrial resection** as part of surgical procedures in cases of cervical cancer. A 48-year-old patient with FIGO stage ib1 squamous cell cancer is shown
Description In single port surgery, the operator provides traction or countertraction, and a hanging over or attraction suture through the abdomen is needed. The most important anatomic landmark for total mesometrial resection is superior hypogastric nerve and both hypogastric nerves and inferior hypogastric plexus. To identify these nerves following procedures are necessary. After extended lymphadenectomy, the pelvic anatomy could be examined more clearly including the superior hypogastric nerve promontory lower part of the aorta common iliac hypogastric vessels hypogastric nerve communicating with parasympathetic nerves and vesicle branches of the inferior hypogastric plexus. Cardinal ligament dissection is as follows. Opening of para vesicle and par rectal spaces vessels in the cardinal ligament were selectively separated. Only superficial and deep uterine vein were coagulated with bipolar forceps or ligature and cut but the neutral part was preserved, located at dorsal medial part of cardinal ligament.
Conclusion/Implications Even though laparoscopic single port radical hysterectomy is difficult, but total mesometrial resection techniques is more difficult. It took a long time 203 minutes and blood loss was 100 ml. 7 days later she can do self-voiding without catheterization. choice between these techniques should be based on surgeon preference and experience, patient anatomy, and other clinical factors. The identification of independent risk factors for survival outcomes may help guide clinical decision-making and improve patient outcomes.
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