Hystérectomie élargie par voie basse ou opération de Schauta-Stoeckel

Abstract

Radical vaginal hysterectomy, also named Schauta's operation, is an old concept. The current use of this surgery has benefited from laparoscopy advances, in particular from laparoscopy-assisted full lymphadenectomies. The procedure begins with a laparoscopic pelvic lymph-node dissection and a laparoscopic assistance of the subsequent vaginal operative steps leading to radical colpohysterectomy, including the resection of the proximal parametrium (Piver II type radical hysterectomy). Indications of radical vaginal hysterectomy are early cervical cancer (stage IA2 or IB1). This surgical technique may result in reduced per and post operative morbidity in comparison with the abdominal approach (Wertheim procedure). Over all, a good knowledge of Schauta's operative technique allows achieving radical trachelectomy, an operation that preserves the fertility of young patients affected by an early cervical cancer.