To complete a difficult radical hysterectomy of cervical cancer through an incision at the size of a melon seed at the umbilicus. This is the first single-hole laparoscopic radical hysterectomy of cervical cancer in our hospital completed by Yu Wang’s team from Department of Obstetrics and Gynecology of Renji Hospital a few days ago. The intraoperative bleeding was only 20ml, and the patient has been ambulant on the next day after operation.

  With the development of minimally invasive techniques, 90% of gynecological malignancies can be completed by ordinary laparoscopy currently. However, with the practice of "Rapid Rehabilitation Concept" and the exploration of minimally invasive techniques, traditional gynecological minimally invasive surgery has gradually taken the new heights of "more minimally invasive" treatment and has been reduced from three to five incisions to only one incision at the umbilicus. This can not only get the same treatment effect, but achieve seamless beauty effects.

  Professor Yu Wang, chief physician from Department of Obstetrics and Gynecology of Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine began to take the lead in single-hole laparoscopic gynecological surgery in Shanghai since 2015. At present, more than 400 cases of single-hole surgery have been completed and have achieved good clinical efficacy. According to her introduction, this case of cervical cancer patient at only 42 years old, required extensive hysterectomy that is the most difficult surgery for gynecologic malignancies. Taking into account the needs of the patient and after rigorous preoperative evaluation, Professor Wang decided to take a single-hole laparoscopic surgery for the patient.

  Compared with the traditional laparoscopic radical hysterectomy, single-hole laparoscopic surgery is extremely difficult due to the coaxial effect, chopsticks effect and so on. Especially it is easy to cause bleeding in lymph node dissection and separation of the ureter and uterine artery of the area, putting forward high requirements for operation skills of the surgeon and familiarity of the pelvic floor anatomy. However, under the same treatment effect, the operation was completed through a 2 cm incision at the umbilicus. All the lesions including the uterus and its surrounding 3 cm uterine artery, the main sacral ligament of the uterus and the vaginal wall were removed. The size of the cervical tumor was 3.5 * 4.0 cm, and the intraoperative bleeding was only 20ml. Compared to traditional laparoscopic surgery, the postoperative pain is slighter, the recovery time is shorter, the body surface scar is smaller, all to achieve a greater extent to meet the physiological and psychological needs of women patients.

  According to Professor Yu Wang’s introduction, single-hole laparoscopy is not only the difference between the number of "holes", but also the breakthrough of minimally invasive concepts and innovation. Single-hole surgery for the treatment of gynecological cancers can better reflect the patient's needs as the center, with treatment principles of humane, individualized and accuracy. In recent years, Yu Wang led the team to continuously overcome technical difficulties in single-hole laparoscopic surgery for gynecological malignancies, and has implemented major surgery for ovarian cancer, endometrial cancer, sentinel lymph node dissection and others, to expand the indications of single-hole surgery from benign diseases to gynecologic malignancies. Gynecological more minimally invasive techniques of Yu Wang’s team have reached the leading position in the country, and have been shown in many major academic conferences at home and abroad. The more minimal invasive concepts also affected the surgical options of academic community for gynecological malignancies.(Correspondent Jun Ma / Translator WeiweiZhang)