Original film of the Okabayashi’s radical hysterectomy by Okabayashi himself in 1932, and two films of the precise anatomy necessary for nerve-sparing Okabayashi’s radical hysterectomy clarified by Shingo Fujii (original) (raw)
Fujii S. Original film of the Okabayashi's radical hysterectomy by Okabayashi himself in 1932, and two films of the precise anatomy necessary for nerve-sparing Okabayashi's radical hysterectomy clarified by Shingo Fujii. Int J Gynecol Cancer 2008;18:383–385. Almost 100 years ago, radical hysterectomy was established by Ernst Wertheim as the surgical technique for the treatment of invasive cervical cancer. However, due to the complicated anatomy of the female pelvis, the method has been modified by many surgeons. Among these modifications, the method by Hidekazu Okabayashi at Kyoto Imperial University in Japan, published in 1921, was more radical and outstanding. Then, Okabayashi's method became a standard surgical procedure for invasive cervical cancer in Japan. We have discovered the historical film of radical hysterectomy performed by Okabayashi himself in 1932. In order to share the information of Okabayashi's radical hysterectomy, we decided to distribute the film through the website of IJGC. Moreover, as the direct descendant of Okabayashi, I have further modified the operation clarifying precise anatomy necessary for Okabayashl's radical hysterectomy. In addition, I also clarified the anatomy necessary for nerve sparing Okabayashi's radical hysterectomy. These two films modified by Shingo Fujii are also available on the IJGC website in the hope that these anatomical findings will be useful for young gynecologic surgeons.
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Precise anatomy of the vesico-uterine ligament for radical hysterectomy
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The Tohoku Journal of Experimental Medicine, 2007
Radical hysterectomy has been performed for invasive cervical cancer, and autonomic nerve-sparing procedures have been developed to preserve bladder function. To perform and improve the nerve-sparing radical hysterectomy, it is important to understand anatomy of the intra pelvic fasciae, specially vesico-uterine ligament (VUL), because most of injuries to the nerves occurred during incision of the VUL in radical hysterectomy procedures. The objectives of the present study were to provide histological understanding of major structures found in nervesparing radical hysterectomy. Serial macroscopic slices (15-20 mm thick) from five female pelves were trimmed and prepared for paraffin-embedded histology. We noted an anatomical entity as "the visceroparietal fascial bridge", which corresponds with the macroscopically identified arcus tendineus fasciae pelvis. A histologically identifiable neurovascular pedicle to the bladder neck corresponded with the deep portion of VUL. These findings could help better preservation of autonomic nerves during radical hysterectomy and improve patient's quality of life after the operation. Translation of surgical anatomy into anatomic terminology enables us to have fruitful discussions with persuasive power by excluding any bias from individual surgeons. vesico-uterine ligament; paracolpium; parietal fascia; levator ani; radial hysterectomy; autonomic nerve
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