What Is Nerve-Sparing Radical Hysterectomy?

  • Shingo Fujii
  • Kentaro Sekiyama


Since Wertheim introduced radical hysterectomy in 1911 [1], his method became the standard procedure for the surgical treatment of cervical cancer in Western Countries. However, in Japan, Takayama and Okabayashi at Kyoto Imperial University thought that Wertheim’s method is not radical enough for invasive cervical cancers. They pursued to create a “better” surgery and Okabayashi established an anatomy oriented method to accomplish more radical surgery than that of Wertheim’s method in 1921 [2]. However, postoperatively both methods have often been associated with severe bladder dysfunction and colorectal motility disorders that adversely impacted the patient’s quality of life.


Okabayashi’s radical hysterectomy Wertheim’s radical hysterectomy Bladder dysfunction Colorectal dysfunction Inferior hypogastric plexus (cross shape) Hypogastric nerve Pelvic splanchnic nerve Bladder branch Nerve-sparing radical hysterectomy T-shaped inferior hypogastric plexus 

Supplementary material

Video 7.1

Concept and Precise Anatomical Steps for Nerve-sparing Radical Hysterectomy (MP4 2282969 kb)


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Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  • Shingo Fujii
    • 1
  • Kentaro Sekiyama
    • 2
  1. 1.Department of Gynecology and ObstetricsKyoto UniversityKyotoJapan
  2. 2.Department of Obstetrics and GynecologyKitano HospitalKita-kuJapan

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