ABSTRACT
The vaginal step of the operation (5,6) is illustrated in Figures 1 to 7. To summarize, the technique is similar to a Schauta (radical vaginal) hysterectomy up to the point when the cardinal ligaments are divided. As this point, uterine arteries are identified and spared, cervical arteries are divided, the isthmus is identified, and the endocervix is divided at least 5 mm below the isthmus, according to Dargent, or preferably 10 mm, according to the Quebec team (7). After removal, the specimen is optionally sent for frozen section (8). Frozen section is not performed when a diagnostic cone biopsy has removed in toto the disease. When some disease is remaining in the cervix, frozen section evaluates the upper margin of resection and the gross distance between malignant growth and margins. Additional excision of the endocervix may be indicated. When the requirements for clear margins cannot be fulfilled without definitively impairing reproductive function of the uterus, the Schauta operation is completed.
