ABSTRACT
In this chapter, the technique of laparoscopic radical hysterectomy will be described in detail. One of the benefits for gynecologic oncologists wishing to learn these techniques is that the same procedure already performed via laparotomy is tailored to laparoscopic instrumentation. The laparoscopic procedure requires a mastery of the standard radical hysterectomy followed by an adaptation to laparoscopic techniques in order to accomplish the required surgical objectives. There are variations in technique, and illustrated here is the use of the argon-beam coagulator for dissection and hemostasis, along with the endoscopic stapler and hemostatic clips. The argon-beam coagulator is set on 70 W of energy with a gas flow of 2 – 4 L/min. The endoscopic stapler is always used with vascular loads, and hemoclips can be placed with a 5-or 10-mm clip applier. Other cautery instrumentation such as the LigaSure or ultrasonic energy devices can also be used.
