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Nerve-Sparing Radical Hysterectomy Using the Okabayashi-Kobayashi Method

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Title: Nerve-Sparing Radical Hysterectomy Using the Okabayashi-Kobayashi Method
Authors: Sakuragi, Noriaki Browse this author →KAKEN DB
Kaneuchi, Masanori Browse this author
Keywords: fascia
paracervical tissues
tissue plane
traction and counter traction
Issue Date: 1-Dec-2021
Publisher: Thieme Medical Publishers
Journal Title: Surgery Journal
Volume: S 02
Start Page: S48
End Page: S56
Publisher DOI: 10.1055/s-0041-1739119
Abstract: Radical hysterectomy (RH) is a standard treatment for early-stage cervical cancer. This surgery extirpates the uterus along with the paracervical tissues, vagina, and the paracolpium to achieve local control. Pelvic lymphadenectomy is a critical component of RH performed for regional control. A clear understanding of pelvic anatomy is critical to safely performing a RH and achieving optimal oncological and functional outcomes. The various surgical steps can damage the pelvic autonomic nerves, and a systematic nerve-sparing technique is used for the preservation of autonomic nerves. There is an intricate vascular network in the lateral paracervix (cardinal ligament) and the pelvic sidewall. We need to comprehend the three-dimensional structure of the vascular and nerve anatomy in the pelvis to perform RH effectively and safely. We can create six spaces around the uterine cervix, including the paravesical spaces, pararectal spaces, a vesicovaginal space, and a rectovaginal space to reveal the target of extirpation. It is critical to find the proper tissue plane separated by the layers of membranous connective tissue (fascia), in order to minimize intraoperative bleeding.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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