Laparoendoscopic Single-site Radical Hysterectomy With Pelvic Lymphadenectomy: Initial Multi-institutional Experience for Treatment of Invasive Cervical Cancer

David M. Boruta, Anna Fagotti, Leslie S. Bradford, Pedro F. Escobar, Giovanni Scambia, Christina L. Kushnir, Chad M. Michener, Amanda Nickles Fader

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


Study Objective: To describe the feasibility, safety, and outcomes of women with stage I cervical cancer treated with laparoendoscopic single-site surgery radical hysterectomy (LESS-RH). Design: A retrospective descriptive study (Canadian Task Force classification III). Setting: Multiple academic teaching hospitals. Patients: Women with Fédération Internationale de Gynécologie et d'Obstétrique FIGO stage IA1 to IB1 cervical cancer. Interventions: LESS-RH as the primary therapy for cervical cancer performed by a gynecologic oncologist with expertise in LESS. A multichannel, single-port access device; a flexible-tipped 5-mm laparoscope; and a multifunctional instrument were used in all cases. Clinicopathologic, surgical, and perioperative outcomes were analyzed. Measurements and Main Results: Twenty-two women were identified in whom a LESS-RH was attempted; 20 (91%) successfully underwent the procedure, including 19 in whom pelvic lymphadenectomy (PLND) was completed. Of the 2 converted procedures, 1 patient underwent 2-port laparoscopy secondary to truncal obesity, and 1 patient underwent conversion to laparotomy secondary to external iliac vein laceration during PLND. The median age and body mass index were 46 years and 23.3 kg/m2, respectively. The median number of pelvic lymph nodes removed was 22. One patient experienced an intraoperative complication, and no patient required reoperation. The margins of excision were negative. One patient with 2 positive pelvic nodes and 1 patient with microscopic parametrial disease received adjuvant chemosensitized radiation; 3 additional patients received adjuvant radiation therapy secondary to an intermediate risk for recurrence. After a median follow up of 11 months, no recurrences were detected. Conclusion: LESS-RH/PLND is feasible and safe for select patients with stage I cervical cancer. Larger studies are needed to confirm whether the increased technical difficulty of this procedure justifies its use in routine gynecologic oncology practice.

Original languageEnglish (US)
Pages (from-to)394-398
Number of pages5
JournalJournal of Minimally Invasive Gynecology
Issue number3
StatePublished - May 2014


  • Cervical cancer
  • Laparoendoscopic single-site surgery
  • Radical hysterectomy

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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