Robotic Radical Hysterectomy for Early-Stage Cervical Cancer

  • Alaa El-GhobashyEmail author
  • San Soo Hoo
  • Javier Magrina


Cervical cancers represent 3.5% of all gynaecological malignancies with a 55% overall 5-year survival. In the United Kingdom, around 3500 cases are diagnosed every year (~9.5–10.5/100,000). This disease results in 1000 deaths annually. The incidence and mortality dropped dramatically in the 1990s due to the impact of the introduction of cervical screening programme. Radical hysterectomy remained the preferred method of treatment for patients with early-stage disease. The operation compromises two components: central resection of the cervix and its surroundings as well as complete removal of the draining regional lymph nodes. In 2006, Sert and Abeler described the first reported robotic-assisted radical hysterectomy (Piver Type III) and bilateral pelvic lymph node dissection for Stage IB1 cervical carcinoma. The operation lasted 7 h and 20 min with an estimated blood loss of 200 mL [1]. The patient was discharged home 4 days later without major complications. Several reports/statements were published in literature supporting the robotic technique and demonstrating its oncological safety [2]. The surgical technique of the robotic radical hysterectomy described in this chapter follows the principles of those originally reported by Okabayashi in 1921 [3], which were designed to minimise the transection of the pelvic autonomic nerves.

Supplementary material

Video 13.1

(WMV 140902 kb)


  1. 1.
    Sert BM, Abeler VM. Robotic-assisted laparoscopic radical hysterectomy (Piver type III) with pelvic node dissection–case report. Eur J Gynaecol Oncol. 2006;27:531–3.PubMedGoogle Scholar
  2. 2.
    Magrina JF, Kho RM, Weaver AL, Montero RP, Magtibay PM. Robotic radical hysterectomy: comparison with laparoscopy and laparotomy. Gynecol Oncol. 2008;109:86–91.CrossRefPubMedGoogle Scholar
  3. 3.
    Okabayashi H. Radical abdominal hysterectomy for cancer of the cervix uteri, modification of the Takayama operation. Surg Gynecol Obstet. 1921;33:335–41.Google Scholar
  4. 4.
    Symmonds RE. Some surgical aspects of gynecologic cancer. Cancer. 1975;36(2):649–60.CrossRefPubMedGoogle Scholar
  5. 5.
    Querleu D, Morrow CP. Classification of radical hysterectomy. Lancet Oncol. 2008;9:297–303.CrossRefPubMedGoogle Scholar
  6. 6.
    Magrina JF, Long JB, Kho RM, Giles DL, Montero RP, Magtibay PM. Robotic transperitoneal infrarenal aortic lymphadenectomy: technique and results. Int J Gynecol Cancer. 2010;20(1):184–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Leblanc E, Narducci F, Frumovitz M, Lesoin A, Castelain B, Baranzelli MC, Taieb S, Fournier C, Querleu D. Therapeutic value of pretherapeutic extraperitoneal laparoscopic staging of locally advanced cervical carcinoma. Gynecol Oncol. 2007;105:304–11.CrossRefPubMedGoogle Scholar
  8. 8.
    Gold MA, Tian C, Whitney CW, Rose PG, Lanciano R. Surgical versus radiographic determination of para-aortic lymph node metastases before chemoradiation for locally advanced cervical carcinoma. A Gynecologic Oncology Group study. Cancer. 2008;112:1954–63.CrossRefPubMedGoogle Scholar
  9. 9.
    Klauschie J, Wechter ME, Jacob K, Zanagnolo V, Montero R, Magrina J, Kho R. Use of anti-skid material and patient-positioning to prevent patient shifting during robotic-assisted gynecologic procedures. J Minim Invasive Gynecol. 2010;17(4):504–7.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of Gynaecological OncologyThe Royal Wolverhampton Hospitals NHS TrustWest MidlandsUK
  2. 2.Mayo ClinicPhoenixUSA

Personalised recommendations