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Explore Laparoscopic Radical Parametrectomy, Upper Vaginectomy & Pelvic Lymphadenectomy | Tips & Tricks with 4,341 views, 603 likes, and 0 comments. Experience the impact of this video content that has captured audience attention.

A 44-year-old patient presented to our clinic after undergoing a total abdominal hysterectomy with bilateral salpingo-oophorectomy at an outside institution approximately one month earlier for cervical intraepithelial neoplasia grade 3 (CIN 3). The final pathology report revealed an endocervical adenocarcinoma with a maximum diameter of 1.1 cm. Histopathological evaluation demonstrated tumour-free surgical margins, absence of lymphovascular space invasion (LVSI), and greater than 50% cervical stromal invasion. Pelvic MRI and clinical examination showed no evidence of residual tumour or suspicious pelvic lymph nodes. The patient was staged as FIGO 2018 stage IB1, and laparoscopic restaging surgery consisting of radical parametrectomy, upper vaginectomy, and pelvic lymphadenectomy was planned. Radical parametrectomy, upper vaginectomy, and pelvic lymphadenectomy are complementary surgical procedures performed in selected cases of cervical cancer, particularly when invasive disease is identified after a simple hysterectomy. The video demonstrates a laparoscopic restaging procedure consisting of radical parametrectomy, upper vaginectomy, and systematic pelvic lymphadenectomy. Key technical highlights include: • Comprehensive retroperitoneal dissection and exposure • Identification and preservation of the ureter throughout its pelvic course • Dissection of the paravesical and pararectal spaces • Nerve-sparing radical parametrectomy • Resection of the upper vagina with adequate oncologic margins • Systematic pelvic lymphadenectomy including obturator and iliac regions • Safe specimen retrieval and meticulous hemostasis The specimens were retrieved using hand-made specimen retrieval bags. The vaginal cuff was then closed using an intracorporeal suturing technique, and meticulous hemostasis was achieved. No drain was placed. The patient was discharged on the morning of postoperative day 3 without any complications. Final pathology of the restaging surgery showed no parametrial involvement, no metastatic lymph nodes, and no tumour in the upper vaginectomy specimen. The previous hysterectomy pathology report had revealed a 0.5 × 1.1 × 0.8-cm endophytic tumour located in the cervical canal, consistent with endocervical adenocarcinoma. Surgical margins were tumour-free, and no LVSI was identified; however, stromal invasion was greater than 50%. Based on these findings, no adjuvant therapy was administered. At 60 months of postoperative follow-up, the patient remained disease-free. TÜRKÇE 44 yaşındaki hastamız, bir ay kadar önce dış merkezde CIN3 nedeniyle total abdominal histerektomi ve bilateral salpingooferektomi yapılmış ve nihai patoloji raporunda (en büyük çapı) 1,1 cm olan endoservikal yerleşimli adenokarsinom olarak raporlandıktan sonra kliniğimize başvurmuştur. Patoloji raporunda; cerrahi sınırlar temiz, LVSI negatif ve %50'den fazla servikal stromal invazyon mevcut seklinde belirtilmişti. Yapılan pelvik MR görüntülemesi ve klinik muayenesinde; residüel tümör ve süpheli pelvik lenf nodu saptanmadı. Hasta 2018 FİGO evrelemesine göre evre IB1 olarak kabul edildi ve laparoskopik yeniden evreleme cerrahisi (radikal parametrektomi, üst vaginektomi ve pelvik lenfadenektomi) planlandı. Radikal parametrektomi, üst vaginektomi ve pelvik lenfadenektomi işlemleri; seçilmiş olgularda, basit histerektomi sonrası invaziv serviks kanseri saptandığında uygulanan tamamlayıcı cerrahi prosedürlerdir. Bu videoda, radikal parametrektomi, üst vaginektomi ve sistematik pelvik lenfadenektomiden oluşan laparoskopik yeniden evreleme cerrahisi sunulmaktadır. laparoscopic radical parametrectomy, upper vaginectomy, pelvic lymphadenectomy, cervical cancer restaging surgery, retroperitoneal anatomy, parametrectomy technique, uterine artery, uretery, uterine vein, internal iliac artery, internal iliac vein, uretery #laparoscopicradicalparametrectomy #uppervaginectomy #pelviclymphadenectomy #cervicalcancerrestagingsurgery #parametrectomytechnique #uterineartery #uretery #uterinevein #internaliliacartery #internaliliacvein #uretery

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