The aim of this study is to assess: 1. Evaluation of the feasibility of laparoscopic nerve sparing radical hysterectomy type III/C1 as regard surgical technique, blood loss and operative time. 2. Evaluate patients' outcome as regard bladder function. in order to preserve the function of the bladder and the rectum, it is necessary to modify the traditional procedures, so as to identify the precise anatomical information directing the technique for optimal preservation of bladder function at the time of radical hysterectomy. The laparoscopic technique offers several well-known advantages. Under the magnified view of the laparoscope, the anatomy can be clearly visualized to allow for the meticulous and precise dissection of the para-cervical structures and areolar tissue, including the blood vessels and the nerves. Laparoscopic identification (neurolysis) of the inferior hypogastric nerve and inferior hypogastric plexus is a feasible procedure for trained laparoscopic surgeons who have a good knowledge not only of the retroperitoneal anatomy but also of the pelvic neuro-anatomy as this qualification could prohibit long-term bladder and voiding dysfunction during nerve-sparing radical hysterectomy
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
46
Unnamed facility
Al Mansurah, Dakahlia Governorate, Egypt
Largo Agostino Gemelli
Roma, RM, Italy
Functional outcome of laparoscopic nerve sparing radical hysterectomy type III/C1
Duration of postoperative catheterization untill PVR urine volume is less than 100 ml
Time frame: 1 month
Intraoperative complications
intraoperative complications
Time frame: During Surgery
Blood loss
Amount of blood intraoperative blood loss in ml. units
Time frame: Day of surgery
Operative time
Minutes for the surgical intervention
Time frame: Day of surgery
Early postoperative complication
Occurence of early postoperative complication within 30 days of operation
Time frame: 30 days
Late postoperative complication
complications related to surgery more than 30 days postoperative
Time frame: more than 30 days postoperative
Bladder training exercise
Removal of urinary catheter on the 3rd day postoperative without prior bladder training exercise and measurement of PVR urine volume
Time frame: 1 month
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