Review Article Open Access J Surgery ISSN: 1584-9341 JOS, an open access journal Volume 11 • Issue 3 • 1 Journal of Surgery [Jurnalul de Chirurgie] J o u r n a l o f S u r g e r y [ J u r n a l u l d e C h i r u r g i e ] ISSN: 1584-9341 Keywords: Cervical cancer; Laparoscopic radical hysterectomy; Robotic surgery hysterectomy Introduction In the early 1990s, the laparoscopic approach in uterine cervical cancer has started to become quite popular among oncologist surgeons in order to minimize postoperative morbidity. When a new surgical technique is taken into consideration or suggested, it is compared with the standard therapy hitherto. Important issues to be taken into account include the feasibility and applicability of the new technique, intraoperative and postoperative complications and in oncological cases, survival and risk of recurrence. Gold standard for uterine cervical cancer in the early stages was abdominal radical hysterectomy with pelvic lymphadenectomy for more than 100 years. Tis technique, described for the frst time Wertheim, Meigs subsequently underwent some changes. Te frst laparoscopic hysterectomy was performed and published in 1989 [1], but the frst laparoscopic radical hysterectomy with pelvic and para- aortic lymphadenectomy in a patient with cervical cancer stage IA2 was performed by Nezha et al. in June 1989 and reported in 1992 [2]. Since then, it has been reported in the literature over 1000 cases [3]. Laparoscopic Surgery versus Open Surgery in Uterine Cervical Cancer Initially used for diagnostic, laparoscopy has become a method of treatment in the feld of gynecological surgery, but also in many other feld. Te results of laparoscopic surgery are now comparable with those obtained by laparotomy in benign and malignant pathologies. Te most important advantages of the laparoscopic technique include more pleasing cosmetic appearance, or minimum parietal infectious complications, low incidence of adhesion formation, low cost associated with hospitalization and recovery period smaller resumption of daily activities in a shorter period [4]. In a study comparing the two surgical techniques, the results show an average of operating time with signifcant diferences statistically 231.7 minutes for cases treated laparoscopically and 207 minutes to classical surgery, which can be explained by the fact that laparoscopic hysterectomies implemented quite recently requires a learning curve. Te surgeons will become more familiar with laparoscopic procedure; the operative time is expected to become shorter. Intraoperative blood loss was lower in the laparoscopy (161.1 ml) compared with the traditional method (394.4 ml), with blood transfusions in 3 patients. Postoperative complications, represented mostly wound infections were recorded only in the group that received radical abdominal hysterectomy. Te hospital stay was less in laparoscopic interventions (mean=2.9 days) compared with the second procedure (mean=5.5 days) [5]. Perino et al. reported similar results for the same parameters for laparoscopic hysterectomies: less hospitalization period (mean=2.4 days versus 6.2 days), minimal intraoperative bleeding (140.0 ml vs 406.0 ml) [6]. A randomized, multicenter study including 116 patients demonstrated that laparoscopic assisted vaginal hysterectomy can be performed in a similar operating time classic surgery with intraoperative blood loss less and a relatively shorter period of hospitalization (p<0.01). Postoperative pain, another important parameter discussed, is lower for the frst 3 days of laparoscopy versus open surgery (p<0.5) [7]. In 2010, Naik et al. published a randomized trial comparing laparoscopic-assisted vaginal radical hysterectomy with abdominal radical hysterectomy in a group of 13 patients (7 patients receiving laparoscopic technique, 6 patients classical intervention) diagnosed with cervical cancer in stage IB1 with a follow-up period of 20 months. Te results from minimally invasive and traditional method are statistically signifcant for the following parameters: catheter maintenance, 4 days versus 21 days, intraoperative blood loss of 400 ml versus 1000 ml, length of stay, less need for analgesics lower. Vaginal *Corresponding author: Nicolae Ioanid, MD, Str. General Berthlot 2-4, Regional Cancer Institute Iași, First Oncologic Surgery Clinic Iași, Romania, Tel: +40 (0) 740 619 863; E-mail: n_ioanid@yahoo.com Received June 02, 2015; Accepted July 15, 2015; Published July 20, 2015 Citation: Gavrilescu MM, Todosi AM, Ioanid N, Scripcariu V. Minimally Invasive Surgery: A New Approach for Uterine Cervical Cancer. Journal of Surgery [Jurnalul de chirurgie]. 2015; 11(3): 93-97 DOI:10.7438/1584-9341-11-3-1 Copyright: © 2015 Gavrilescu MM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Initially used for diagnostic, laparoscopy has become a method of treatment in the feld of gynecological surgery, but also in many other felds. The results of laparoscopic surgery are now comparable with those obtained by laparotomy in benign and malignant pathologies. Laparoscopy provides improved results in the short term and at least equivalent results in terms of long-term recurrence when compared with open surgery. Robotic-assisted laparoscopy was performed to prevent the disadvantages of conventional laparoscopy. It emerged as a revolutionary technology and has spread in less than a decade in many surgical felds, including urology, cardiothoracic surgery, pediatric surgery and general surgery. Minimally invasive techniques provide a lower rate of complications during surgery as compared to open surgery, which is appropriate tissue due to handling and better anatomical views. Laparoscopic treatment of cervical cancer provides benefts on increasing comfort with decreased convalescence time, but these cases should be reserved for surgeons with extensive experience in laparoscopic procedures. One of the most important advantages of minimally invasive surgical techniques is the short duration of hospitalization. Minimally Invasive Surgery: A New Approach for Uterine Cervical Cancer Mihaela Mădălina Gavrilescu 1 , Ana-Maria Todosi 1 , Nicolae Ioanid 2* and Viorel Scripcariu 1 1 First Oncologic Surgery Clinic, Regional Cancer Institute, "Gr. T. Popa" University of Medicine and Pharmacy Iași, Romania 2 Oncologic Gynecology Unit, Regional Cancer Institute, Iași, Romania