Radical Vaginal Hysterectomy

Abstract

Radical vaginal hysterectomy (RVH) was first described by Shauta in 1908. At that time, RVH was performed more often than abdominal radical hysterectomy for cervical carcinoma due to its lower surgical invasiveness. However, RVH was selected only for early cases because lymphadenectomy was impossible to perform. Recently, RVH has developed into laparoscopically assisted radical vaginal hysterectomy (LARVH), which is associated with the laparoscopic procedure, and it is applied as radical vaginal trachelectomy and semi-radical vaginal hysterectomy. In this chapter, we commented on LARVH. LARVH is indicated for patients with stage IB1 and IIA1 cervical carcinoma, especially those with a tumor size of less than 2 cm, because the cardinal ligaments cannot be resected widely. Pergialiotis et al. reported that LARVH provided equal recurrence-free rates to abdominal radical hysterectomy when it is performed in patients with tumors that do not exceed 2 cm in the greatest diameter. Although RVH that is associated with laparoscopic pelvic lymphadenectomy is the most used surgical procedure, radical trachelectomy may be performed either abdominally or vaginally (laparoscopic or robotic). One report found that the pregnancy rate was higher in patients who underwent minimally invasive or radical vaginal trachelectomy than in those who underwent radical abdominal trachelectomy.