Table 1

The most important points regarding the radicality and the clarity of nerve-sparing surgical steps for each technique

ArticleRadicalityNerve-sparing surgical steps
Ventral parametriumLateral parametriumDorsal parametriumVaginal vault/paracolpiumBladder branchesPelvic splanchnic nerveHypogastric nerveInferior hypogastric plexus
Raspagliesi et al+++Restricted to only 2 cm because of omitting the maneuver to isolate the inferior hypogastric plexus and lateralize it before resection of the vaginal vault+
(The description and the figures do not match our current knowledge about the exact course of the pelvic splanchnic nerves)
By misunderstanding the course of the pelvic splanchnic nerve, the preparation of the inferior hypogastric plexus is missed
Charoenkwan et al+++Not described+
Hoeckel et al++Restricted at the anterior vaginal wall+
Possover et al/Koehler et al-/++++Vaginal cuff (only one third) but without any paracolpium+
(Middle rectal artery is the landmark)
Yabuki et al+++++/-++
Uses the Yabuki space as a landmark, which is difficult to be developed as we do not have reliable anatomical landmarks to define it. Yabuki space itself will highlight only the deep layer of vesico-uterine ligament. The bladder branches reside in the lateral side of the vaginal wall and not in the vesico-uterine ligament
Sakuragi et al++++++++
No precise steps to prepare the ventral parametrium isolating the bladder branches of the inferior hypogastric plexus
Fujii et al++++++++