Conventional Laparoscopic Hysterectomy Research Articles

Surgical outcomes of single port lapraroscopic radical hysterectomy in cervical cancer.

e17003 Background: We aim to see the postoperative outcomes of single port laparoscopic radical hysterectomy in cervical cancer. Methods: Twenty five cervical cancer patients (FIGO stage 9 IA, 13 IB, and 3 IIA) were treated by single port laparoscopic radical hysterectomy in single center. Results: Six patients were performed by type A hysterectomy, 6 by type B, and 13 by type C radical hysterectomy. Median operation time was 91, 197, and 275 minutes, respectively. Median number of pelvic nodes retrieved was 20. There was no postoperative complication except a colon serosa injury in type C radical hysterectomy and which repaired by single port approach. Ten out of 25 patients got an adjuvant radiation therapy and there were 3 recurrences (1 in type A, 2 in type C). Median disease free survival was 9.5 months in type A, 14 months in type C. Conclusions: Single port radical hysterectomy is safe and comparable to conventional laparoscopic hysterectomy in cervical cancer

Perioperative surgical outcome of conventional and robot-assisted total laparoscopic hysterectomy

BackgroundTo evaluate surgical outcome in a consecutive series of patients with conventional and robot assisted total laparoscopic hysterectomy.MethodsA retrospective cohort study was performed among patients with benign and malignant indications for a laparoscopic hysterectomy. Main surgical outcomes were operation room time and skin to skin operating time, complications, conversions, rehospitalisation and reoperation, estimated blood loss and length of hospital stay.ResultsA total of 294 patients were evaluated: 123 in the conventional total laparoscopic hysterectomy (TLH) group and 171 in the robot TLH group. After correction for differences in basic demographics with a multivariate linear regression analysis, the skin to skin operating time was a significant 18 minutes shorter in robot assisted TLH compared to conventional TLH (robot assisted TLH 92m, conventional TLH 110m, p0.001). The presence or absence of previous abdominal surgery had a significant influence on the skin to skin operating time as did the body mass index and the weight of the uterus.Complications were not significantly different. The robot TLH group had significantly less blood loss and lower rehospitalisation and reoperation rates.ConclusionsThis study compares conventional TLH with robot assisted TLH and shows shorter operating times, less blood loss and lower rehospitalisation and reoperation rates in the robot TLH group.

Robotic-assisted hysterectomy: patient selection and perspectives.

Minimally invasive hysterectomy via the laparoscopic or vaginal approach is beneficial to patients when compared with laparotomy, but has not been offered in the past to all women because of the technical difficulties and the long learning curve required for laparoscopic hysterectomy. Robotic-assisted hysterectomy for benign indications may allow for a shorter learning curve but does not offer clear advantages over conventional laparoscopic hysterectomy in terms of surgical outcomes. In addition, robotic hysterectomy is invariably associated with increased costs. Nevertheless, this surgical approach has been widely adopted by gynecologic surgeons. The aim of this review is to describe specific indications and patients who may benefit from robotic-assisted hysterectomy. These include hysterectomy for benign conditions in cases with high surgical complexity (such as pelvic adhesive disease and endometriosis), hysterectomy and lymphadenectomy for treatment of endometrial carcinoma, and obese patients. In the future, additional evidence regarding the benefits of single-site robotic hysterectomy may further modify the indications for robotic-assisted hysterectomy.

Impact of a Fellowship-Trained Minimally Invasive Gynecologic Surgeon on Patient Outcomes.

Background and Objectives:As the performance of minimally invasive hysterectomy has increased in the United States, the need to apply outcomes measures has also increased. This study was conducted to determine the impact of a fellowship-trained minimally invasive gynecologic surgery (MIGS) specialist on patient outcomes after laparoscopic hysterectomy (LH) in a gynecology department.Methods:This is a retrospective review of 218 patients who underwent a laparoscopic hysterectomy for benign indications at a suburban academic-affiliated tertiary care hospital with a broad patient base from 2010 to 2014.Results:A total of 218 women underwent conventional laparoscopic hysterectomy by 10 members of a gynecology department: 96 women (44%) by a MIGS specialist and 122 women (56%) by a group of general gynecologists. Operative time was less (119 vs 148 min; P < .001), and patients were more likely to be discharged on the same day (90.6% vs 66.4%; P < .001) for the MIGS specialist compared to other surgeons. More patients of the MIGS specialist had undergone prior laparotomies (42.7% vs 17.2%; P = < .001) and had a greater uterine weight (392 vs 224 g; P < .001). Although the difference was not statistically significant, conversion to laparotomy (0 vs 2 cases; P = .505) and postoperative infection (6 vs 16 cases; P = .095) were lower for the MIGS specialist. Total billing charges were also lower for the MIGS specialist ($9,920 vs $11,406; P < .001).Conclusion:A fellowship-trained MIGS specialist performed laparoscopic hysterectomy in less time on more difficult surgical patients, with a shorter length of stay and lower costs, and no difference in complications compared to other providers in a gynecology department.

An evaluation of laparoscopic hysterectomy alone versus in combination with laparoscopic myomectomy for patients with uterine fibroids

ObjectiveThe purpose of this study was to compare surgical outcomes following conventional laparoscopic hysterectomy (LH) (C-LH) versus the combination method of LH plus laparoscopic myomectomy (LM) (LH+LM) for the treatment of large uterine fibroids. Study designThis study was performed in 56 patients (uterine weights ≥500g) who underwent either C-LH or LH+LM performed by the same surgeon between May 2010 and May 2016. LH+LM was performed when C-LH was problematic because of poor visibility and/or mobility due to uterine fibroids. ResultsThe C-LH and LH+LM groups consisted of 27 (48%) and 29 (52%) patients, respectively. The clinical characteristics of patients differed significantly only in the median sizes of the dominant fibroid. The sizes of the dominant fibroid in the C-LH and LH+LM groups were 9.5cm and 10.7cm (P=0.04), respectively. Regarding the surgical outcomes for the C-LH and LH+LM groups, the median uterine weights were 558g and 737g (P=0.03), respectively, the median operating times were 156min and 173min (P=0.23), respectively, and the median intraoperative blood losses were 150g and 300g (P=0.0004), respectively. In all patients, LH was performed without conversion to laparotomy and there were no cases of bladder, ureteral, or gastrointestinal tract injury. There were no postoperative complications of Clavien-Dindo scale≥III in either group. ConclusionsWhen C-LH cannot be performed because of large uterine fibroids that cause poor visibility and/or mobility, LH+LM may allow the procedure to be successfully completed without conversion to laparotomy. However, the latter approach increases the risk for intraoperative blood loss.

Discharge Readiness Following Conventional Laparoscopic and Robotic-Assisted Hysterectomy

Evaluate patient readiness for discharge following conventional laparoscopic (TLH) and robotic-assisted hysterectomy (RA-TLH).

The clinical experience of robot-assisted surgery in gynecologic cancer

The comparison of robotic and conventional laparoscopic hysterectomy and pelvic lymphadenectomy in gynecologic cancer still needs to be studied. In all, 98 consecutive cases of patients with gynecologic cancer undergoing robot-assisted hysterectomy and pelvic lymphadenectomy, and another 98 consecutive cases of conventional laparoscopic hysterectomy and pelvic lymphadenectomy during the same period in the Obstetrics and Gynecology Hospital of Fudan University were included. The duration of the operation, blood loss, drainage during the first 24 h after the operation, total hospital stay, hospital stay after the operation, lymph nodes collected, perioperative complications, and the cost of each operation for both procedures were recorded. The duration of the operation was longer, and the cost of each operation was almost seven times higher in the robot group than that in the conventional laparoscopy group. But the differences with regard to blood loss, drainage during the first 24 h after the operation, total hospital stay, hospital stay after operation, the lymph nodes collected, and the rate of perioperative complications were not statistically significant. Robot-assisted surgery (RAS) in gynecologic cancer is as feasible as conventional laparoscopic surgery. We recommend further studies about the cost and effect of RAS in gynecologic cancer.

Incidence and Prevention of Vaginal Cuff Dehiscence Following Laparoscopic and Robotic Hysterectomy: A Systematic Review and Meta-Analysis.

ABSTRACT Objective Vaginal cuff dehiscence, a severe and potentially detrimental complication, has significantly increased after the introduction of endoscopic hysterectomy. The aim of this systematic review and meta-analysis of the available literature was to identify the incidence of, and possible strategies to prevent, this complication after total laparoscopic hysterectomy and total robotic hysterectomy. Data Sources PubMed, ClinicalTrials.gov, Scopus, and Web of Science databases were systematically queried to identify all articles reporting either laparoscopic or robot-assisted hysterectomies for benign indications in which vaginal dehiscence was reported as an outcome. Reference lists of the identified studies were manually searched. Only papers written in English were considered. Methods of Study Selection The Population, Intervention, Comparison, and Outcome framework for the review included (1) population of interest: women who underwent conventional and robot-assisted laparoscopic hysterectomy; (2) interventions: possible methods to prevent vaginal dehiscence; (3) comparison: experimental strategies vs standard treatment or alternative strategy for each item of intervention; and (4) outcome: rate of vaginal dehiscence. Series of subtotal hysterectomies and radical hysterectomies in addition to reports that combined both benign and malignant cases were excluded. The meta-analysis was performed using RevMan version 5.4.1 (Cochrane Training, London, United Kingdom). Two independent reviewers identified all reports comparing 2 or more possible strategies to prevent vaginal dehiscence. Tabulation, Integration, and Results A total of 460 articles were identified. Of these, 20 (6 randomized, 2 prospective, and 12 retrospective) studies were included in this review for a total of 19 392 patients. The incidence of vaginal dehiscence after total laparoscopic hysterectomy ranged between 0.64% and 1.35%. Robotic hysterectomy was associated with a risk of vaginal dehiscence of approximately 1.64%. No study compared early vs delayed resumption of coital activity nor analyzed the role of training in laparoscopic suturing. No study specifically assessed the impact of electrosurgery on the risk of vaginal dehiscence in endoscopic hysterectomies for benign indications. Double-layer and reinforced sutures did not decrease the risk of dehiscence. Barbed sutures reduced the risk of separation compared with nonbarbed closure (0.4% [4/1108] vs 2% [22/1097]; odds ratio [OR] 0.25; 95% confidence interval [CI], 0.11–0.57). However, these data came mainly from retrospective series. Excluding studies on the use of self-anchoring sutures during robotic hysterectomy, there was no significant difference in the risk of dehiscence between barbed and nonbarbed sutures (0.5% [4/890] vs 1.4% [181/776]; OR 0.38; 95% CI, 0.13–1.10). Transvaginal suture of the vault at the end of an endoscopic hysterectomy seemed to increase the risk of dehiscence when compared with laparoscopic closure (2.3% [23/1002] vs 1.16% [11/944]; OR 1.97; 95% CI, 1.00–3.88). Conclusion There is a paucity of high-quality papers evaluating vaginal dehiscence and possible prevention strategies in the current literature. Only 2 effective strategies have been identified in reducing the risk for this complication: the use of barbed sutures and the adoption of a laparoscopic approach to close the vaginal cuff. When restricting the analysis only to laparoscopic cases, the use of barbed sutures does not protect against vaginal cuff separation.

Laparoendoscopic Single-Site Surgery: Scarless Stitchless Hysterectomy

Abstract Background: Hysterectomy is the most common gynecologic surgery. Approximately 600,000 hysterectomies are performed annually in the United States. Hysterectomy has increasingly been performed using minimally invasive approaches, which offer advantages, such as early recovery and return to routine activities, improved cosmesis, shorter length of hospital stay, and reduced pain, compared with laparotomy. Conventional laparoscopic hysterectomy consists of 3–4 incisions where separate ports are placed, one for laparoscope access and 2–3 for surgical instruments' access. One technique for reducing the invasiveness of conventional laparoscopy is laparoendoscopic single-site surgery—scarless stitchless hysterectomy (LESS-SSH). The technique involves no stitching of the skin incision, although there are vaginal stitches, and does not create scars. Objective: The aim of this study was to evaluate the feasibility of LESS-SSH and analyze its benefits. Materials and Methods: This was a prospective observatio...

Same-Day Discharge After Laparoscopic Hysterectomy for Endometrial Cancer.

The aim of this study was to investigate the relationship between same-day discharge (SDD) and postoperative complications within 30 days of laparoscopic hysterectomy for endometrial cancer and endometrial intraepithelial neoplasia (EIN). This single-institution retrospective cohort included all patients who underwent conventional and robotic-assisted laparoscopic hysterectomy for endometrial cancer or EIN in a large teaching hospital between 2011 and 2013. Temporal trends in frequency of SDD and rates of postoperative complications were investigated to assess whether adoption of routine SDD was associated with increased postoperative complications. Associations between SDD and postoperative complications were also investigated in univariate and multivariate models. Overall, 696 patients underwent laparoscopic hysterectomy. Of these, 37.1 % had pelvic lymphadenectomy, 3.0 % had para-aortic lymphadenectomy, and 9.3 % underwent omentectomy. The rate of SDD increased from 3.9 to 69.6 % during the study period (p < 0.001), and the frequency of postoperative readmission, unscheduled surgery, infection, and composite complications within 30 days of hysterectomy did not differ during the study period. The composite complication rate did not differ significantly between patients who underwent surgery before and after the adoption of routine SDD (rate ratio 0.7, 95 % CI 0.4-1.2, p = 0.24). After controlling for demographic, intraoperative, and comorbid factors, patients who underwent SDD were not at increased risk for postoperative complications. Adoption of routine SDD after laparoscopic surgery for endometrial cancer and EIN did not result in increased complication rates within our institution. A larger prospective study is required to definitively establish the safety of this approach.

Single-port Access Subtotal Laparoscopic Hysterectomy: A Prospective Case-Control Study.

The objective was to evaluate the perioperative outcomes, safety, and patient acceptance of single-port access laparoscopic subtotal hysterectomy (SPAL-SH) in comparison with conventional multiport access laparoscopic subtotal hysterectomy (MPAL-SH). Case-control study. Canadian Task Force Classification II-2. The study was conducted at university hospitals in Cagliari, Italy, and Rouen, France. Sixty-one women with metrorrhagia, abnormal uterine bleeding with uterine myomas, or symptomatic adenomyosis were included in the study. Thirty-one patients underwent SPAL-SH, and 30 patients underwent conventional MPAL-SH. We analyzed the data to compare the outcomes of SPAL-SH versus MPAL-SH. Patients in the SPAL-SH group had longer operative times than those in the MPAL-SH group (p < .001) but shorter hospital stays (p < .001). Postoperative pain immediately after surgery, after 6 hours, and after 24 hours were lower in the SPAL-SH group (p < .001). The SPAL-SH group reported significantly higher cosmetic satisfaction at 1, 4, and 24 weeks after surgery (p < .01). We conclude that SPAL-SH is a feasible and safe alternative to standard MPAL-SH in selected patients. Ongoing refinement of the surgical technique and instrumentation is likely to expand its role in gynecologic surgery in the future. In addition, SPAL-SH has a definite benefit in relation to body image and cosmesis.

Duplication of Conventional Multiport Laparoscopic Radical Hysterectomy Steps with Other Minimal Access Modalities (LESS, OASIS, Robotic).

To duplicate the steps of conventional multiport laparoscopic radical hysterectomy by 3 other minimal access modalities: robotic radical hysterectomy, laparoendoscopic single-site surgery (LESS), and orifice-assisted small-incision surgery (OASIS). Institutional Review Board approval was obtained. Between January 2009 and December 2012, the charts of the patients who had undergone radical hysterectomy by these 4 minimal access modalities were analyzed. Galaxy Care Laparoscopy Institute, Pune, India. Fifteen patients in each arm with stage IB1 cervical cancer with a histopathological report of squamous cell carcinoma were analyzed. All patients had undergone radical hysterectomy by a conventional multiport, robotic, LESS, or OASIS technique. The type of procedure was decided by joint consultancies of doctor and patient. All patients were analyzed retrospectively for time, blood loss, oncologic clearance, and complications. The median follow-up of all patients was 12 months (range, 8-18 months). The "Pune technique" of radical hysterectomy consists of 6 steps: (1) posterior U cut; (2) dissection of pouch of Douglas; (3) pararectal space dissection; (4) anterior U cut; (5) uretric tunnel dissection; and (6) ilio-obturator lymph node dissection. The radical hysterectomy is a type B radical hysterectomy. Proper patient selection plays an important role in radical hysterectomy with different minimal access operative modalities. Parametrium clearance of 2.25 to 3.5 cm can be obtained with different modalities [1-5]. As of the writing of this report, none of the 60 patients evaluated had experienced recurrence, and all are disease-free. The study period was 4 years. To conclude, our data indicate that the steps of conventional multiport radical hysterectomy by the Pune technique can be duplicated by other minimal access modalities, including robotic radical hysterectomy, LESS, and OASIS.

Feasibility of laparoendoscopic single-site surgery in supracervical hysterectomy: technique and retrospective case-control comparison

One recent innovation in the field of gynecology is laparoendoscopic single-site surgery (LESS). It is associated with reduced postoperative pain and better cosmetic outcome. The present paper aims to explain techniques and instrumentations associated with single-port hysterectomies. A retrospective case-control study is included, comparing LESS with conventional four-port hysterectomies to highlight the feasibility of LESS. This study involved literature search and personal experience regarding single-port hysterectomy and a retrospective case-control study of 34 patients who underwent supracervical hysterectomy between April 2011 and November 2012. Operating time, blood loss, and length of hospital stay were similar in the two groups. Patient’s evaluation of the cosmetic result was in favor of LESS, however not significant. LESS represents a new frontier in minimally invasive surgery. New instrumentation and recommendations have been developed which are expected to make the technique more feasible. This study demonstrates that LESS supracervical hysterectomy has comparable operative outcomes to conventional laparoscopic hysterectomy and is a feasible approach for supracervical hysterectomy. Based on the literature and our experience, a feasible step by step technique for surgeons who are interested in performing supracervical LESS hysterectomy is described. Comparative data and prospective trials are required in order to determine the clinical utility and impact of LESS in treatment of gynecological conditions in the future.

Single-port access versus conventional multi-port access total laparoscopic hysterectomy for very large uterus.

ObjectiveThe aim of this study was to compare the surgical outcomes of single-port access (SPA) and conventional multi-port access total laparoscopic hysterectomies (TLH) among patients with very large uteri (500 g or more).MethodsFifty consecutive patients who received TLH for large uterine myomas and/or adenomyoses weighing 500 g or more between February 2009 and December 2012 were retrospectively reviewed. SPA and conventional TLH were each performed in 25 patients. Surgical outcomes, including operation time, estimated blood loss, postoperative hemoglobin change, postoperative hospital stay, postoperative pain, and perioperative complications, were compared between the two groups.ResultsThere were no significant demographic differences between the two groups. All operations were completed laparoscopically with no conversion to laparotomy. Total operation time, uterus weight, estimated blood loss, and postoperative hemoglobin change did not significantly differ between the two groups. Postoperative hospital stay was significantly shorter for the SPA-TLH group compared to that of the conventional TLH group (median [range], 3 [2.0-6.0] vs. 4 [3-7] days; P=0.004]. There were no inter-group differences in postoperative pain at 6, 24, and 72 hours after surgery. There was only one complicated case in each group.ConclusionSPA-TLH in patients with large uteri weighing 500 g or more is as feasible as conventional TLH. SPA-TLH is associated with shorter hospital stays compared to that of conventional TLH.

The McCarus-Volker ForniSee® System: A Novel Transilluminating Colpotomy Device and Uterine Manipulator for Use in Conventional and Robotic-Assisted Laparoscopic Hysterectomy

To introduce a novel transilluminating colpotomy and uterine manipulator device, demonstrate its safety and adequate clinical performance in conventional and robotic-assisted laparoscopic hysterectomy, and illustrate its potential widespread future use in minimally invasive gynecologic procedures.

Laparoendoscopic single-site hysterectomy with Ligasure is better than conventional laparoscopic assisted vaginal hysterectomy

Objective: To determine an ideal route and device in hysterectomy by comparing laparoendoscopic single-site (LESS) hysterectomy with conventional laparoscopic-assisted vaginal hysterectomy (LAVH). Methods: This is a computed clinical pathway based caseecontrol study performed in the Buddhist Tzu Chi General Hospital, Hualien, Taiwan. Seventy-two patients (36 LESS hysterectomies and 36 LAVH) from May 2011 to August 2013 were included. The choice of route of hysterectomy and Ligasure use during the operation were made by the patient or by economic considerations. Perioperative outcomes, including postoperative visual analog scale for pain and analgesic pain-relief score were compared. Results: Surgical time and length of hospital stay were shorter in LESS hysterectomy than in LAVH (126 ± 47.7 minutes vs. 158 ± 60.7 minutes and 4.7 ± 0.8 days vs. 5.4 ± 0.8 days, respectively). The visual analog scale pain scores at 0e2 hours and 24 hours postoperation were significantly lower in LESS hysterectomy than in LAVH (5.68 ± 2.11 vs. 8.14 ± 1.46 and 3.75 ± 1.61 vs. 5.04 ± 1.28, respectively). Overall, the pain score decreased by 30%, 26%, and 12% at 0e2 hours, 24 hours, and 48 hours, respectively, after the operation. The total pain-relief score was 38.2% lower in LESS hysterectomy than in LAVH (1.15 ± 0.44 vs. 1.86 ± 0.33; p < 0.001). There were comparable adverse events in both groups. Conclusion: This study demonstrated that LESS hysterectomy with Ligasure is superior to conventional LAVH.

Nerve-Sparing Radical Hysterectomy Made Easy by Laparoscopy

Study ObjectiveTo evaluate the technical feasibility of nerve-sparing radical hysterectomy performed laparoscopically. PatientsThirty-five women with cervical cancer stage Ia1 or Ib1. InterventionsAll patients underwent laparoscopic nerve-sparing hysterectomy. Measurements and Main ResultsOncologic results were comparable to those of conventional laparoscopic radical hysterectomy. There was complete recovery of bladder function after removal of the Foley catheter. Results of urodynamic studies at 3 weeks after surgery were normal. ConclusionOncologic and functional results are comparable to those of conventional laparoscopic radical hysterectomy. Magnification enabled by laparoscopy is helpful in better dissection and preservation of nerve anatomy.

Solo surgery – Early results of robot-assisted three-dimensional laparoscopic hysterectomy

Objective: Report of our initial experience in laparoscopic hysterectomy by a solo surgeon using a robotic camera system with three-dimensional visualisation. Material and methods: This novel device (Einstein Vision®, B. Braun, Aesculap AG, Tuttlingen, Germany) (EV) was used for laparoscopic supracervical hysterectomy (LASH) performed by one surgeon. Demographic data, clinical and surgical parameters were evaluated. Our first 22 cases, performed between June and November 2012, were compared with a cohort of 22 age-matched controls who underwent two-dimensional LASH performed by the same surgeon with a second surgeon assisting. Results: Compared to standard two-dimensional laparoscopic hysterectomy, there were no significant differences regarding duration of surgery, hospital stay, blood loss or incidence of complications. The number of trocars used was significantly higher in the control group (p <.0001). All hysterectomies in the treatment group were performed without assistance of a second physician. Conclusion: Robot-assisted solo surgery laparoscopic hysterectomy is a feasible and safe procedure. Duration of surgery, hospital stay, blood loss, and complication rates are comparable to a conventional laparoscopic hysterectomy.

Physician Risk Estimation of Operative Time: A Comparison of Risk Factors for Prolonged Operative Time in Robotic and Conventional Laparoscopic Hysterectomy

Abstract Objective: The Physician Risk Estimation of Operative Time (PREOpT) project is an effort to identify patient characteristics associated with prolonged operative time in patients undergoing robotic or conventional laparoscopic total hysterectomy. Methods: A retrospective cohort study of 1290 cases of robotic and conventional laparoscopic total hysterectomy was performed over 2 years. Univariate, bivariate, and predictive analysis were performed to determine associations between patient characteristics and prolonged operative time. Setting: The study was performed in urban gynecologic practices in a tertiary care teaching hospital. Results: Of 1290 patients who underwent minimally invasive hysterectomy, 732 patients had conventional laparoscopic hysterectomy (TLH) and 558 had robotic hysterectomy (RTH). Prolonged operative time was defined as ≥180 minutes. Mean operative time for all cases was 115.79 minutes (standard deviation [SD]±60.37). Obesity was associated with increased operative time (odds...

Single-Site Laparoscopic Radical Hysterectomy Using Conventional Ports and Instruments

Study ObjectiveTo study the technical feasibility of performing a radical hysterectomy via laparoscopic single-site surgery LESS. PatientA 45-year-old woman with cervical cancer stage IA2. InterventionBiopsy report showed invasive keratinizing squamous cell carcinoma, grade II. We duplicated the steps of our “Pune technique” of laparoscopic radical hysterectomy to perform a radical hysterectomy via laparoscopic single-site surgery using conventional ports and instruments. Measurements and Main ResultsOncologic clearance was comparable to that of conventional laparoscopic radical hysterectomy. Operative time was 120 minutes, and blood loss was 50 mL. ConclusionReduced port laparoscopic radical hysterectomy is technically feasible. Oncologic clearance and functional results are comparable to those of the multiport variant, with good cosmetic results.