Can "membrane bridge" be used to describe the connective tissue between two different embryonic compartments? An exploratory attempt to standardize the description of embryonic compartment hysterectomy

Abstract

Standardized surgical procedures are crucial for preventing recurrence and ensuring a favorable prognosis in cervical cancer patients. The primary surgical challenge lies in the circumferential en bloc resection of the tissues surrounding the cervix and paravaginal area. This region's complex vascular and neural distribution increases the risk of bleeding, injury, and other surgical complications, which in turn heightens the risk of local tumor recurrence. Recently, the concept of total mesometrial resection (TMMR) guided by embryonic origin principles has shown promise in reducing postoperative recurrence rates. The technique focuses on using embryonic boundaries as surgical margins and entering through avascular planes, thereby minimizing complications while achieving favorable oncological outcomes. However, due to inconsistencies with traditional anatomical terms and surgical approaches, this method has yet to gain widespread adoption. Our team has conducted preliminary explorations into embryonic compartmental-based hysterectomy, yielding encouraging results. We have introduced the concept of the "membrane bridge" to standardize surgical procedures, facilitating the broader adoption of this technique. Due to the unique advantage of the three-dimensional view provided by robotic surgery, we utilized images from robotic procedures to illustrate the different "membrane bridges."