General Session I—120 Years After Radical Hysterectomy: Origin, Evolution, and Influence on Benign Gynecologic Surgery


Day 2: Monday, November 12, 2018


4:45 – 6:00 pm


Marcello Ceccaroni


Vito Chiantera, Amanda Nickles Fader, Brandon Michael Lingenfelter, Ido Sirota, Pamela T. Soliman, Kimberly Levinson, Wendy Winer (OR Nurse)


On the 16th of November 1898 in Vienna, Ernst Wertheim performed the first Radical Hysterectomy, changing forever the history of pelvic surgery. During these last 120 years the surgical improvement of this procedure has been followed in parallel by the evolution of technology and anatomo-surgical concepts of parametrial ligaments. Many schools in Japan, Europe and America adopted the evolution by proposing different surgical strategies (i.e. vaginal, Coelio-Shauta, abdominal, laparoscopic, robotic) and lesser-invasive procedures (i.e. nerve-sparing surgery, modulation of radicality, radical trachelectomy). Due to the evolution, Parametrial surgery is more than a pure oncologic procedure and has progressed into a cornerstone of radical procedures for benign pathology

This course provides a detailed analysis on the evolution of benign gynecologic surgery, exploiting the direct anatomical feedbacks from cadaveric dissections performed laparoscopically, robotically and by combined vaginal-laparoscopic route. Each modality will be compared to highlight the correct surgical strategies of parametrial surgery from oncological to benign infiltrative diseases.

Learning Objectives

At the conclusion of this course, the clinician will be able to: 1) Explore the history and modern evolutions of Radical Hysterectomy and parametrial surgery; 2) discuss the “different shades of parametria”, according to the different surgical anatomies of the procedures proposed; and 3) determine the best surgical tips for facing tricky benign diseases, safely opening the retroperitoneum.

Course Outline

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