Gasless Laparoscopic-Assisted Radical Vaginal Hysterectomy with Lymphadenectomy for Cervical Carcinoma.

We performed gasless lymph node dissection in a woman with cervical carcinoma FIGO stage Ib. The dissection of the parametrium was done vaginally by hysterectomy including the Schuchardt incision and the removal of 2 cm of vagina. We removed 45 lymph nodes. For the laparoscopic procedures we used a Laparofan and Laparolift (Origin Medsystems). The estimated blood loss was 250 ml and operative time 330 minutes. An advantage of the gasless method is that one can use endoscopic and conventional instruments. We combined advantages of laparoscopy (good visibility, enlargement of blood and lymph vessels) and of the gasless method (use of the same instruments as in laparotomy, quick change of endoscopic and conventional instruments without gas loss). This technique achieves the same surgical results as radical laparotomy in selected women with cervical carcinoma.