Ospan Mynbaev | Moscow Institute of Physics and Technology (original) (raw)
Papers by Ospan Mynbaev
ABSTRACT Objective: to systematically review mechanisms of respiratory and cardiovascular disturb... more ABSTRACT Objective: to systematically review mechanisms of respiratory and cardiovascular disturbances are associated with CO2-pneumoperitoneum during laparoscopic procedures. Methods: An acquisition of original manuscripts published since 1990 were performed from PubMed and other internet databases in English language according to relevant key words. 3 reviewers screened abstracts using pre-defined criteria and obtained full-text manuscripts. 4 reviewers selected relevant studies and analyzed them. Disagreements were resolved by consultation with all other coauthors and by consensus. The outcome of interest was mechanisms of respiratory and cardiovascular disturbances during laparoscopic procedures and postsurgical complications. Among sources we found reviews summarizing CO2-pneumoperitoneum pathophysiology, and 50 of 128 original papers concerning clinical impact of CO2-pneumoperitoneum on conditions of patients and 37 of 154 studies on experimental models were analyzed: 15 in pigs; 4-dogs; 7-rabbits; 9-rats; 2-mice. Results: Broad spectrum of questions and hypotheses were explored to investigate an impact of CO2-pneumoperitoneum during laparoscopic surgery. An impact of CO2-gas, its physical and chemical properties, including humidity, temperature, desiccations, insufflation pressure and time on systemic blood gas, acid base and oxygen/oxymetry parameters, cardiovascular/respiratory functions, as well as local intraperitoneal disturbances in peritoneal tissue, parenchimatous organs and blood circulation were extensively studied in terms of course of laparoscopic surgery and recovery of patients as well as the rate of intraoperative and postsurgical complications. In conclusion, on the basis of analysis of clinical and experimental studies the authors summarized that carbon dioxide is the most convenient and physiologically optimal gas for pneumoperitoneum, when it applied in accordance with safety regulations.
ABSTRACT Objective was to demonstrate the software is meant for global CO2 balance monitoring dur... more ABSTRACT Objective was to demonstrate the software is meant for global CO2 balance monitoring during laparoscopic procedures. Study design and methods: We presumed that the determining mechanisms of blood gas and acid base balance changes during laparoscopic surgery are an intraperitoneal pressure, CO2-pneumoperitoneum time and CO2 elimination ability of respiratory system. Subsequently the design of the software is based on blood gas changes are strictly associated with intraperitoneal pressure and CO2-pneumoperitoneum time in a rabbit model. Results: According to the physical law CO2 moves from abdominal cavity-to-peritoneal tissue, from peritoneal tissue-to-venous blood and from venous-to-arterial blood stream. Subsequently the framework is settled as computational implementation of mathematical model describing global CO2 balance and its transport. We divided the whole CO2 transportation network to several compartments: mesothelial layer diffusion in the abdominal cavity and CO2 inflow from peritoneum tissue to venous capillaries, CO2 transportation in arterial and venous blood stream, and alveolar gas exchange in the lungs controlled by the respiration rate. The core mathematics embraces mass balance was coupled with ability of respiratory system to eliminate CO2 gas in rabbit model. Conclusions: The software allows monitoring a global balance of accumulated CO2 in peritoneal tissue, venous/arterial blood stream and calculating the rate of respiratory parameters required to remove an excess amount of CO2 depending on the ability of respiratory system in order to avoid systemic blood gas acid base balance complications during CO2-pneumoperitoneum.
Two mathematical approaches are proposed for carbon dioxide redistribution modellig due to abdomi... more Two mathematical approaches are proposed for carbon dioxide redistribution modellig due to abdominal CO 2 insufflation during CO 2 -pneumoperitoneum. The main objective of this work is studying artificial ventilation parameters during laparoscopic procedure in order to decrease risk for specific patient.
Elasticity of the living abdominal wall in laparoscopic surgery. Song C, Alijani A, Frank T, Hann... more Elasticity of the living abdominal wall in laparoscopic surgery. Song C, Alijani A, Frank T, Hanna G, Cuschieri A. J Biomech. 2006; 39(3):587-91. Mechanical properties of the human abdominal wall measured in vivo during insufflation for laparoscopic surgery. Song C, Alijani A, Frank T, Hanna GB, Cuschieri A. Surg Endosc. 2006; 20(6):987-90.
Archives of Gynecology and Obstetrics, 2015
Gynecological Endocrinology, 2015
The usefulness of various pathways inhibitors, Everolimus, an inhibitor of mammalian target of ra... more The usefulness of various pathways inhibitors, Everolimus, an inhibitor of mammalian target of rapamycin (mTOR), Infliximab, a monoclonal antibody which blocks the tumor necrosis factor-a (TNF-a), Erlotinib, a tyrosine protein kinase inhibitor of the epidermal growth factor receptor (EGFR), Metformin, an activator of AMP-activated protein kinase enzyme (AMPK) and vascular permeability reducers were explored in an ovarian hyperstimulation syndrome (OHSS) rat model. Sixty-three female Wistar rats were randomly divided in seven groups. The control group received saline, while the OHSS group received recombinant -- follicle-stimulating hormone (rec-FSH) for four consecutive days. The other five groups received rec-FSH for 4 d and Everolimus daily, Infliximab once, Erlotinib daily, Metformin daily and Vitamin C daily, respectively. All groups received human chorionic gonadotropin (hCG) at the fifth day. The efficacy of Everolimus administration for various intervals was also explored. Significantly reduced ovarian weight was observed in the Everolimus group (rec-FSH + hCG + mTOR inhibitor) compared to the OHSS group (p < 0.001). The Everolimus group also showed the lowest progesterone (PRG) concentration (p = 0.007). The Erlotinib group (rec-FSH + hCG + EGFR inhibitor) presented with the lowest graafian follicle number, while the Everolimus group was characterized by the lowest corpus luteum number. The vascular permeability and the estradiol levels did not differ between groups. Finally, the Everolimus intra-comparison showed no difference in all measured outcomes. Studying the different pathways linked to vascular endothelial growth factor (VEGF) pathway, we conclude that targeting mTOR pathways is beneficial for reducing ovarian weight and PRG levels in an OHSS animal model.
International Journal of Nanomedicine, 2015
Patologicheskaia fiziologiia i èksperimental'naia terapiia
Experimental models were used to examine the impact of corrections of the uterine horns on the ac... more Experimental models were used to examine the impact of corrections of the uterine horns on the activity of tissue plasminogen activator (tPA). The application of sutures was shown to suppress the activity of tPA in the uterine horns to a greater extent than other surgical techniques. With this, the use of catgut caused the highest suppression of tPA activity and increases in the frequency and density of formation of postoperative adhesions. Depleted tPA reserves and its higher inhibitor levels were found to lead to depressed fibrinolysis, which is a pathogenetic factor for developing an adhesive process.
Biulleten' eksperimental'noĭ biologii i meditsiny, 1995
Biulleten' eksperimental'noĭ biologii i meditsiny, 1993
30 rabbits were operated on by sigmoidal ovarian resection during which one side was treated with... more 30 rabbits were operated on by sigmoidal ovarian resection during which one side was treated with fibrin glue, and alternative with different suturing materials (prolene 7/0, catgut 3/0). Macroscopic investigations and determination of generative functions of postoperative animals, in a 3 weeks after coupling with male rabbits, were carried out. It was discovered that the application of fibrin glue promotes the reduction of in inflammatory and sclerotic changes. The frequency of occurred postoperative adhesions and preservation of increasing the ovarian size and weight tendency with the maintained functional conditions in comparison with those treated with suture materials. Prolene has certain advantages when compared with catgut, like macroscopic changes in the ovarian tissues, resulting in decrease of ovarian size and weight, increase of formation of postoperative adhesions and unbalance the whole generative system. In clinics fibrin glue was applied to 7 patients during different...
Biulleten' eksperimental'noĭ biologii i meditsiny, 1993
The study of the efficacy of the use of different materials recommended for the adhesion preventi... more The study of the efficacy of the use of different materials recommended for the adhesion prevention was carried out in 15 white rats. On the parietal front-lateral peritoneum of the abdomen, adhesion formation was induced using an adhesion induction model of 10--nodes suture (catgut 3/0) both sides. In the experimental group, fibrin glue FG1 produced at the Surgery Centre of the Russian Academy of Medical Sciences, and oxidized cellulose barrier-Interceed, manufactured by the Johnson & Johnson company (USA); were applied while the control group was made up of the untreated rodents. 5 days after the operation, these animals were opened and the degree of the spread, type, intensity and rigidity of the formed adhesion were studied using the grade system. It was observed, that fibrin glue and Interceed barrier never caused any tissue reaction; a reduction in the frequency of adhesion formation was also noted in the treated group.
Biulleten' eksperimental'noĭ biologii i meditsiny, 1993
Our investigation consisted in 10-days treatment of vaginal mucous membrane wounds in white not i... more Our investigation consisted in 10-days treatment of vaginal mucous membrane wounds in white not inbred rats by introduction of natural cytokines complex into the vagina. At the same time the dynamics of vaginal phagocytes oxygen-depended function change was studied. We have ascertained the activating influence of the cytokines complex on the phagocytes chemiluminescence (CL) that found expression in 2.5-7 times fold augmentation of the CL intensity in comparison with control level (an equal portion of Medium--199 was introduced in the vagina of control-group rats). Having ended the application of the cytokines complex we have observed a rather fast normalization of the cells' activity (by the 15-17 days), consequently the cytokines did not have a distant effect on the oxygen-depended phagocytes function. We consider the activation of the phagocytes in wound as well as the bactericidal effect of the oxygen free radicals generated by the phagocytes as positive result.
Voprosy kurortologii, fizioterapii, i lechebnoĭ fizicheskoĭ kultury
The experiments on 50 animals were made to evaluate efficacy of electrophoresis of hyaluronidase ... more The experiments on 50 animals were made to evaluate efficacy of electrophoresis of hyaluronidase (from actinohyal solution) against adhesions. Model abdominal adhesions in rats were exposed to hyaluronidase coming from anode and cathode for 20 min. There were altogether 10 daily procedures. The control animals received the solvent from the same poles or were not exposed to electrophoresis. The results demonstrate that hyaluronidase introduction from anode and cathode significantly decreases the occurrence and density of postoperative adhesions compared to controls.
International Journal of Nanomedicine, 2014
Cervical cancer remains the leading cause of death by gynecologic cancer worldwide, comprising 15... more Cervical cancer remains the leading cause of death by gynecologic cancer worldwide, comprising 15% of all cancers in women younger than 40 years. Standard treatments of invasive cancer in early stages are radical hysterectomy and pelvic radiotherapy, both of which are almost reliable by minimal invasive surgery, so as traditional laparoscopy and robotic-assisted surgery. Moreover, 45% of reproductive-age women are diagnosed with stage IB1 disease, making the fertility-sparing procedure, radical trachelectomy, a viable option for most patients for treatment of early-stage cervical cancer and maintenance of future fertility. This chapter focuses on emerging surgical techniques, including the laparoscopic and robotic approach, are improving perioperative outcomes for these patients. A manual and computer-aided search was carried out for all reviews related to this topic, randomized controlled trials, prospective observational studies, retrospective studies and case reports published between 1980 and 2012, assessing robotic surgery, Search strings were: laparoscopic surgery; robot or robot-assisted surgery; radical hysterectomy; cervical cancer, minimally invasive surgery. Robotic-assisted gynecologic surgery has increased worldwide, considering the number of scientific articles dedicated to it though few retrospective and prospective studies have demonstrated the feasibility of robotic-assisted surgery in radical hysterectomy. In general, robot-assisted gynecologic surgery is often associated with longer operating room time but generally similar clinical outcomes, decreased blood loss, and shorter hospital stay. Robotic-assisted procedures are not, however, without their limitations: the equipment is still very large, bulky, and expensive, the staff must be trained, specifically on draping and docking the apparatus to maintain efficient operative times. Functional limitations include lack of haptic feedback, limited vaginal access, limited instrumentation, and larger port incisions. Exchanging instruments becomes more cumbersome and requires a surgical assistant to change the instruments. Additionally, the current robotic instruments do not include endoscopic staplers or vessel sealing devices. Finally, laparoscopic radical hysterectomy is a feasible and safe procedure that is associated with fewer intraoperative and postoperative complications than abdominal radical hysterectomy. The role of robotic-assisted surgery is continuing to expand, but well-designed, prospective studies with well-defined clinical, long-term outcomes, including complications, cost, pain, return to normal activity, and quality of life, are needed to fully assess the value of this new technology in radical hysterectomy. Scientific literature has shown the feasibility of a radical resection by minimally invasive oncological surgery and documented an equivalent number of pelvic nodes harvested by laparoscopy and open surgery. Women with a tumor size 2 cm or smaller and stage IA1 with lymphovascular space involvement (LVSI), IA2, or IB1 disease may be offered fertility-sparing treatment after thorough evaluation by an oncologist trained in this management.
ABSTRACT Objective: to systematically review mechanisms of respiratory and cardiovascular disturb... more ABSTRACT Objective: to systematically review mechanisms of respiratory and cardiovascular disturbances are associated with CO2-pneumoperitoneum during laparoscopic procedures. Methods: An acquisition of original manuscripts published since 1990 were performed from PubMed and other internet databases in English language according to relevant key words. 3 reviewers screened abstracts using pre-defined criteria and obtained full-text manuscripts. 4 reviewers selected relevant studies and analyzed them. Disagreements were resolved by consultation with all other coauthors and by consensus. The outcome of interest was mechanisms of respiratory and cardiovascular disturbances during laparoscopic procedures and postsurgical complications. Among sources we found reviews summarizing CO2-pneumoperitoneum pathophysiology, and 50 of 128 original papers concerning clinical impact of CO2-pneumoperitoneum on conditions of patients and 37 of 154 studies on experimental models were analyzed: 15 in pigs; 4-dogs; 7-rabbits; 9-rats; 2-mice. Results: Broad spectrum of questions and hypotheses were explored to investigate an impact of CO2-pneumoperitoneum during laparoscopic surgery. An impact of CO2-gas, its physical and chemical properties, including humidity, temperature, desiccations, insufflation pressure and time on systemic blood gas, acid base and oxygen/oxymetry parameters, cardiovascular/respiratory functions, as well as local intraperitoneal disturbances in peritoneal tissue, parenchimatous organs and blood circulation were extensively studied in terms of course of laparoscopic surgery and recovery of patients as well as the rate of intraoperative and postsurgical complications. In conclusion, on the basis of analysis of clinical and experimental studies the authors summarized that carbon dioxide is the most convenient and physiologically optimal gas for pneumoperitoneum, when it applied in accordance with safety regulations.
ABSTRACT Objective was to demonstrate the software is meant for global CO2 balance monitoring dur... more ABSTRACT Objective was to demonstrate the software is meant for global CO2 balance monitoring during laparoscopic procedures. Study design and methods: We presumed that the determining mechanisms of blood gas and acid base balance changes during laparoscopic surgery are an intraperitoneal pressure, CO2-pneumoperitoneum time and CO2 elimination ability of respiratory system. Subsequently the design of the software is based on blood gas changes are strictly associated with intraperitoneal pressure and CO2-pneumoperitoneum time in a rabbit model. Results: According to the physical law CO2 moves from abdominal cavity-to-peritoneal tissue, from peritoneal tissue-to-venous blood and from venous-to-arterial blood stream. Subsequently the framework is settled as computational implementation of mathematical model describing global CO2 balance and its transport. We divided the whole CO2 transportation network to several compartments: mesothelial layer diffusion in the abdominal cavity and CO2 inflow from peritoneum tissue to venous capillaries, CO2 transportation in arterial and venous blood stream, and alveolar gas exchange in the lungs controlled by the respiration rate. The core mathematics embraces mass balance was coupled with ability of respiratory system to eliminate CO2 gas in rabbit model. Conclusions: The software allows monitoring a global balance of accumulated CO2 in peritoneal tissue, venous/arterial blood stream and calculating the rate of respiratory parameters required to remove an excess amount of CO2 depending on the ability of respiratory system in order to avoid systemic blood gas acid base balance complications during CO2-pneumoperitoneum.
Two mathematical approaches are proposed for carbon dioxide redistribution modellig due to abdomi... more Two mathematical approaches are proposed for carbon dioxide redistribution modellig due to abdominal CO 2 insufflation during CO 2 -pneumoperitoneum. The main objective of this work is studying artificial ventilation parameters during laparoscopic procedure in order to decrease risk for specific patient.
Elasticity of the living abdominal wall in laparoscopic surgery. Song C, Alijani A, Frank T, Hann... more Elasticity of the living abdominal wall in laparoscopic surgery. Song C, Alijani A, Frank T, Hanna G, Cuschieri A. J Biomech. 2006; 39(3):587-91. Mechanical properties of the human abdominal wall measured in vivo during insufflation for laparoscopic surgery. Song C, Alijani A, Frank T, Hanna GB, Cuschieri A. Surg Endosc. 2006; 20(6):987-90.
Archives of Gynecology and Obstetrics, 2015
Gynecological Endocrinology, 2015
The usefulness of various pathways inhibitors, Everolimus, an inhibitor of mammalian target of ra... more The usefulness of various pathways inhibitors, Everolimus, an inhibitor of mammalian target of rapamycin (mTOR), Infliximab, a monoclonal antibody which blocks the tumor necrosis factor-a (TNF-a), Erlotinib, a tyrosine protein kinase inhibitor of the epidermal growth factor receptor (EGFR), Metformin, an activator of AMP-activated protein kinase enzyme (AMPK) and vascular permeability reducers were explored in an ovarian hyperstimulation syndrome (OHSS) rat model. Sixty-three female Wistar rats were randomly divided in seven groups. The control group received saline, while the OHSS group received recombinant -- follicle-stimulating hormone (rec-FSH) for four consecutive days. The other five groups received rec-FSH for 4 d and Everolimus daily, Infliximab once, Erlotinib daily, Metformin daily and Vitamin C daily, respectively. All groups received human chorionic gonadotropin (hCG) at the fifth day. The efficacy of Everolimus administration for various intervals was also explored. Significantly reduced ovarian weight was observed in the Everolimus group (rec-FSH + hCG + mTOR inhibitor) compared to the OHSS group (p < 0.001). The Everolimus group also showed the lowest progesterone (PRG) concentration (p = 0.007). The Erlotinib group (rec-FSH + hCG + EGFR inhibitor) presented with the lowest graafian follicle number, while the Everolimus group was characterized by the lowest corpus luteum number. The vascular permeability and the estradiol levels did not differ between groups. Finally, the Everolimus intra-comparison showed no difference in all measured outcomes. Studying the different pathways linked to vascular endothelial growth factor (VEGF) pathway, we conclude that targeting mTOR pathways is beneficial for reducing ovarian weight and PRG levels in an OHSS animal model.
International Journal of Nanomedicine, 2015
Patologicheskaia fiziologiia i èksperimental'naia terapiia
Experimental models were used to examine the impact of corrections of the uterine horns on the ac... more Experimental models were used to examine the impact of corrections of the uterine horns on the activity of tissue plasminogen activator (tPA). The application of sutures was shown to suppress the activity of tPA in the uterine horns to a greater extent than other surgical techniques. With this, the use of catgut caused the highest suppression of tPA activity and increases in the frequency and density of formation of postoperative adhesions. Depleted tPA reserves and its higher inhibitor levels were found to lead to depressed fibrinolysis, which is a pathogenetic factor for developing an adhesive process.
Biulleten' eksperimental'noĭ biologii i meditsiny, 1995
Biulleten' eksperimental'noĭ biologii i meditsiny, 1993
30 rabbits were operated on by sigmoidal ovarian resection during which one side was treated with... more 30 rabbits were operated on by sigmoidal ovarian resection during which one side was treated with fibrin glue, and alternative with different suturing materials (prolene 7/0, catgut 3/0). Macroscopic investigations and determination of generative functions of postoperative animals, in a 3 weeks after coupling with male rabbits, were carried out. It was discovered that the application of fibrin glue promotes the reduction of in inflammatory and sclerotic changes. The frequency of occurred postoperative adhesions and preservation of increasing the ovarian size and weight tendency with the maintained functional conditions in comparison with those treated with suture materials. Prolene has certain advantages when compared with catgut, like macroscopic changes in the ovarian tissues, resulting in decrease of ovarian size and weight, increase of formation of postoperative adhesions and unbalance the whole generative system. In clinics fibrin glue was applied to 7 patients during different...
Biulleten' eksperimental'noĭ biologii i meditsiny, 1993
The study of the efficacy of the use of different materials recommended for the adhesion preventi... more The study of the efficacy of the use of different materials recommended for the adhesion prevention was carried out in 15 white rats. On the parietal front-lateral peritoneum of the abdomen, adhesion formation was induced using an adhesion induction model of 10--nodes suture (catgut 3/0) both sides. In the experimental group, fibrin glue FG1 produced at the Surgery Centre of the Russian Academy of Medical Sciences, and oxidized cellulose barrier-Interceed, manufactured by the Johnson & Johnson company (USA); were applied while the control group was made up of the untreated rodents. 5 days after the operation, these animals were opened and the degree of the spread, type, intensity and rigidity of the formed adhesion were studied using the grade system. It was observed, that fibrin glue and Interceed barrier never caused any tissue reaction; a reduction in the frequency of adhesion formation was also noted in the treated group.
Biulleten' eksperimental'noĭ biologii i meditsiny, 1993
Our investigation consisted in 10-days treatment of vaginal mucous membrane wounds in white not i... more Our investigation consisted in 10-days treatment of vaginal mucous membrane wounds in white not inbred rats by introduction of natural cytokines complex into the vagina. At the same time the dynamics of vaginal phagocytes oxygen-depended function change was studied. We have ascertained the activating influence of the cytokines complex on the phagocytes chemiluminescence (CL) that found expression in 2.5-7 times fold augmentation of the CL intensity in comparison with control level (an equal portion of Medium--199 was introduced in the vagina of control-group rats). Having ended the application of the cytokines complex we have observed a rather fast normalization of the cells' activity (by the 15-17 days), consequently the cytokines did not have a distant effect on the oxygen-depended phagocytes function. We consider the activation of the phagocytes in wound as well as the bactericidal effect of the oxygen free radicals generated by the phagocytes as positive result.
Voprosy kurortologii, fizioterapii, i lechebnoĭ fizicheskoĭ kultury
The experiments on 50 animals were made to evaluate efficacy of electrophoresis of hyaluronidase ... more The experiments on 50 animals were made to evaluate efficacy of electrophoresis of hyaluronidase (from actinohyal solution) against adhesions. Model abdominal adhesions in rats were exposed to hyaluronidase coming from anode and cathode for 20 min. There were altogether 10 daily procedures. The control animals received the solvent from the same poles or were not exposed to electrophoresis. The results demonstrate that hyaluronidase introduction from anode and cathode significantly decreases the occurrence and density of postoperative adhesions compared to controls.
International Journal of Nanomedicine, 2014
Cervical cancer remains the leading cause of death by gynecologic cancer worldwide, comprising 15... more Cervical cancer remains the leading cause of death by gynecologic cancer worldwide, comprising 15% of all cancers in women younger than 40 years. Standard treatments of invasive cancer in early stages are radical hysterectomy and pelvic radiotherapy, both of which are almost reliable by minimal invasive surgery, so as traditional laparoscopy and robotic-assisted surgery. Moreover, 45% of reproductive-age women are diagnosed with stage IB1 disease, making the fertility-sparing procedure, radical trachelectomy, a viable option for most patients for treatment of early-stage cervical cancer and maintenance of future fertility. This chapter focuses on emerging surgical techniques, including the laparoscopic and robotic approach, are improving perioperative outcomes for these patients. A manual and computer-aided search was carried out for all reviews related to this topic, randomized controlled trials, prospective observational studies, retrospective studies and case reports published between 1980 and 2012, assessing robotic surgery, Search strings were: laparoscopic surgery; robot or robot-assisted surgery; radical hysterectomy; cervical cancer, minimally invasive surgery. Robotic-assisted gynecologic surgery has increased worldwide, considering the number of scientific articles dedicated to it though few retrospective and prospective studies have demonstrated the feasibility of robotic-assisted surgery in radical hysterectomy. In general, robot-assisted gynecologic surgery is often associated with longer operating room time but generally similar clinical outcomes, decreased blood loss, and shorter hospital stay. Robotic-assisted procedures are not, however, without their limitations: the equipment is still very large, bulky, and expensive, the staff must be trained, specifically on draping and docking the apparatus to maintain efficient operative times. Functional limitations include lack of haptic feedback, limited vaginal access, limited instrumentation, and larger port incisions. Exchanging instruments becomes more cumbersome and requires a surgical assistant to change the instruments. Additionally, the current robotic instruments do not include endoscopic staplers or vessel sealing devices. Finally, laparoscopic radical hysterectomy is a feasible and safe procedure that is associated with fewer intraoperative and postoperative complications than abdominal radical hysterectomy. The role of robotic-assisted surgery is continuing to expand, but well-designed, prospective studies with well-defined clinical, long-term outcomes, including complications, cost, pain, return to normal activity, and quality of life, are needed to fully assess the value of this new technology in radical hysterectomy. Scientific literature has shown the feasibility of a radical resection by minimally invasive oncological surgery and documented an equivalent number of pelvic nodes harvested by laparoscopy and open surgery. Women with a tumor size 2 cm or smaller and stage IA1 with lymphovascular space involvement (LVSI), IA2, or IB1 disease may be offered fertility-sparing treatment after thorough evaluation by an oncologist trained in this management.