If a patient meets criteria for extrafascial hysterectomy for early-stage cervical cancer, how do you determine your surgical approach (abdominal vs laparoscopic)?  

For FIGO 1A1-1A2 (i.e., microinvasion which means no visible lesion) - I would perform a vaginal hysterectomy with bilateral salpingectomy (IA1) or robotic hysterectomy with bilateral salpingectomy-nodes (IA2); for FIGO 1B1 with no visible lesion (eg., post-conization), I would perform a robotic cys...

We shifted our surgical approach for radical hysterectomies due to the LACC trial, which did not include stage IA1 without LVSI. Criteria for extrafascial hysterectomies include tumor size less than 2 cm. In the SHAPE trial, recurrence rates were similar between those who had minimally invasive surg...

The LACC trial was a randomized, controlled trial of laparoscopic versus open radical hysterectomy in patients with cervical cancers less than or equal to 4 cm in size. This trial demonstrated reduced disease free and overall survival in patients who underwent laparoscopic radical as compared to ope...