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++++++++