Learning Laparoscopic Radical Hysterectomy: Are We Facing an Emerging Situation?

Author:

Moufawad Graziella1,Laganà Antonio Simone2ORCID,Habib Nassir3,Chiantera Vito2,Giannini Andrea4ORCID,Ferrari Federico56ORCID,Vitagliano Amerigo7ORCID,Della Corte Luigi8ORCID,Bifulco Giuseppe9,Sleiman Zaki1ORCID

Affiliation:

1. Department of Obstetrics and Gynecology, Lebanese American University Medical Center-Rizk Hospital, Beirut 1100, Lebanon

2. Unit of Gynecologic Oncology, ARNAS “Civico—Di Cristina—Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy

3. Obstetrics and Gynecology Department, Francois Quesnay Hospital, 78200 Mantes-La-Jolie, France

4. Department of Medical and Surgical Sciences and Translational Medicine, PhD Course in “Translational Medicine and Oncology”, Sapienza University, 00185 Rome, Italy

5. Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy

6. Division of Obstetrics and Gynecology, ASST Spedali Civili di Brescia, 25123 Brescia, Italy

7. Unit of Obstetrics and Gynecology, Department of Biomedical and Human Oncologic Science, University of Bari, 70100 Bari, Italy

8. Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80138 Naples, Italy

9. Department of Public Health, University of Naples Federico II, 80138 Naples, Italy

Abstract

Despite wide screening campaigns and early detection, cervical cancer remains the fourth most common cancer among women. Radical hysterectomy, whether by open, laparoscopic or by robotic-assisted techniques, is the mainstay treatment. However, for adequate surgical results and good oncological prognosis, a gynecological surgeon should be trained to perform those procedures. The learning curve of radical hysterectomy, especially by laparoscopy, is influenced by several factors. The LACC trial, the decrease in cervical cancer incidence and radical hysterectomy procedures have widely reduced the learning curve for surgeons. This article mainly discusses the learning curve of laparoscopic radical hysterectomy for cervical cancers, and how several factors are influencing it negatively, with the need to have medical authorities reset specific surgical training programs and allocate them to special oncological centers.

Publisher

MDPI AG

Subject

Health, Toxicology and Mutagenesis,Public Health, Environmental and Occupational Health

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