Total laparoscopic radical hysterectomy using Lee-Huang portal and McCartney transvaginal tube

A surgical approach to the treatment of invasive cervical carcinoma 1b1 may result in decreased mortality and morbidity as well as better functional quality of life. Laparoscopic-assisted radical vaginal hysterectomy (LARVH) is an alternative treatment for early cervical cancer, with parts of the procedures performed vaginally. We modified LARVH to total laparoscopic radical hysterectomy (TLRH) using Lee-Huang portal and McCartney transvaginal tube. The advantage of TLRH for cervical cancer is that the entire procedure is performed under direct observation. It may reduce the possibility of visceral organ injury during vaginal procedures and could minimize vaginal bleeding due to dissection. The Lee-Huang portal as primary laparoscopic port affords wide access to the abdominal cavity and proper visual angle, and increases the working distance. A plastic McCartney transvaginal tube placed inside the vagina maintains pneumoperitoneum and performs a circular incision on the vagina around the uterus with ease. Our preliminary experience with 12 patients suggests that this method of TLRH is feasible for selected patients and may be a useful alternative in treating early cervical cancer.