Laparoscopic Radical Hysterectomy: Pune Technique

The gold standard treatment of uterine cancer is radical hysterectomy. With technological advances, radical hysterectomy can now be performed with minimally invasive techniques, such as laparoscopy and robotics. Laparoscopic procedure offers less post-operative pain, an early recovery of the patient, allowing the patient to take up adjuvant treatment as early as possible and overall a good quality of life of the patient. In this chapter, the “Pune technique” of laparoscopic radical hysterectomy is described by the authors with operative steps that are standardised. It makes this technique universally acceptable as it is easily duplicable. Knowledge of avascular spaces of pelvis and understanding of anterior parametrium makes this technique unique with lesser recurrence rate. Laparoscopic radical hysterectomy is onco-logically comparable to open surgery in terms of margins, lymph node clearance, and parametric resection, resulting in a successful type III radical hysterectomy. It is technically feasible and economically viable, and it has less postoperative complications and lower morbidity than the abdominal approach. We can replicate the traditional steps of multiport laparoscopic radical hysterectomy using alternative minimally invasive techniques such as LESS (Laparo endoscopic Single-Site Surgery), OASIS (One-Access Surgery), and Robotic surgery.