LAUSR

The role of minimally invasive radical hysterectomy for cervical cancer has been questioned since the publication of the Laparoscopic Approach to Cervical Cancer (LACC) trial results. However, it is likely that the lower survival rates shown in the minimally invasive surgery (MIS) arm were not directly related to the MIS itself, but rather to technical procedures linked to laparoscopic and roboticassisted approaches. These include the use of uterine manipulators or the opening of the vagina through the abdominal cavity. Laparoscopically assisted radical vaginal hysterectomy (LARVH) or CoelioSchauta procedure combines lymph node staging and pelvic space creation by laparoscopy with radical hysterectomy including parametriumparacolpium resection performed predominantly by vaginal approach, as reported by Schauta. This technique has shown oncological results and surgical complications comparable with those reported for the open surgery arm of the LACC trial. During LARVH, colpotomy and closure of the vagina are performed at the beginning of the radical hysterectomy, precluding manipulation of the tumor during the procedure. We present a stepbystep video demonstration of the LARVH technique as it has been performed for more than 25 years at Hospital Clinic of Barcelona following the surgical technique described by Dargent and Querleu to treat earlystage cervical cancer patients. This is a 37 yearold patient diagnosed with a 3.5 cm squamous cervical cancer, International Federation of Gynecology and Obstetrics (FIGO) stage IB2, who underwent a Figure 1 Final specimen shows the vaginal cuff and parametria resected.