Laparoscopic Radical Hysterectomy: Traditional and Nerve-Sparing Technique

The traditional and nerve-sparing techniques of laparoscopic radical hysterectomy will be described here. The degree of radicality in both techniques is similar but in the latter the sympathetic (hypogastric nerve and pelvic plexus) and parasympathetic (pelvic splanchnic nerves and pelvic plexus) innervation is preserved. Whenever possible, the nerve-sparing technique is preferable since bladder function and vaginal lubrication are better preserved without compromising recurrence or survival. This technique is more commonly used in Japan, where it originated (Tokyo method), and in some European centers in Italy, Belgium, and Germany. It is uncommonly used in United States.