Robotic-Assisted Radical Hysterectomy (RRH) as Nerve-Sparing Procedure

Abstract

Nerve-sparing radical hysterectomy (NSRH) is procedure to preserve pelvic autonomic nerves and provides ealier return of bladder function, better vaginal blood flow, and fewer symptoms related to anorectal function. Pelvic autonomic nerves compose of superior hypogastric plexus, pelvic splanchnic nerves, sacral splanchnic nerves, inferior hypogastric plexus, and vesical branch of infeior hypogastric plexus. Advanced robotic technologies including exellent 3-dimensional image amplication, articulating movement of the robotic arms, lack of tremor, and strable traction and contertraction have given us easy differentiation and preservation of pelvic autonomic nerves. In this chapter, we will discribe the concept of nerve-sparing radical hystrectomy and its detail robotic surgical technique by step by step with detail surgical images.