Controversies surrounding type III radical abdominal hysterectomy and its procedure using new instruments

Type III radical abdominal hysterectomy (RAH) is standard care for early stage cervical cancer. For the past few decades, there has been a remarkable shift from surgery to radiation, in the treatment choice for stage 1b2 and 2b cervical cancer in Japan. It is still controversial, however because some of those cases recommended RAH as a suitable treatment strategy. About 8% to 10% of RAH are abandoned because of tumor status. Recent preoperative screening cannot always detect them preoperatively. Various kinds of new surgical instruments, such as bipolar scissors and the electro vessel sealing system LigaSure have contributed to reducing the operation time and blood loss, in performing RAH. Furthermore, various kinds of devices are on the market. Surgeons should choose suitable instruments depending on the state of the disease and the patient.