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Background <p>The recently published SHAPE trial<sup><CitationRef CitationID="CR1">1</CitationRef></sup> may limit the exposure of trainees to modified radical hysterectomy, Querleu-Morrow type B<sup><CitationRef CitationID="CR2">2</CitationRef></sup>. It is therefore timely to reestablish a simple description of the technique with an educational video.</p> Materials and Methods <p>The steps of the Type B1 (modified radical hysterectomy) (Fig. <InternalRef RefID="Fig1">1</InternalRef>) are as follows: step 1: preparation of lateral, ventral, and dorsal spaces (three steps); step 2: management of the uterine artery and of the parauterine lymphovascular tissue; step 3: unroofing of the ureter, division of the vesicouterine ligaments, and mobilization of the bladder base; step 4: division of the rectovaginal ligaments; and step 5: division of the paracervix at the ureter.</p> Results <p>The B2 variant, characterized by adding a lateral paracervical lymph node dissection, and the recently described parauterine lymphovascular tissue (PULT)<sup><CitationRef CitationID="CR3">3</CitationRef>,<CitationRef CitationID="CR4">4</CitationRef></sup> resection, will be also featured. Here are the steps for additional paracervical lymphadenectomy: step 1: separation from the obturator nerve; step 2: separation from the paravesical tissue; step 3: removing the ventral component of the paracervix (lateral “parametrium”); step 4: removing the dorsal component of the paracervix (internal iliac nodes); and step 5: removing the lateral component of the paracervix (presciatic nodes).</p> Conclusions <p>In this video, we analyzed the surgical technique for type B radical hysterectomy, focusing on dissection of the uterus and lymph nodes, including the PULT. This highlights the importance of maintaining standardization of the procedure throughout the generations of gynecologic oncologists.</p>

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Radical Hysterectomy: A Focus on Querleu–Morrow Type B

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月20日

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  • Nicolò Bizzarri,
  • Giacomo Guidi,
  • Sara Ammar,
  • Andrea Rosati,
  • Luigi Pedone Anchora,
  • Francesco Fanfani,
  • Anna Fagotti,
  • Giovanni Scambia,
  • Denis Querleu

摘要

Background

The recently published SHAPE trial1 may limit the exposure of trainees to modified radical hysterectomy, Querleu-Morrow type B2. It is therefore timely to reestablish a simple description of the technique with an educational video.

Materials and Methods

The steps of the Type B1 (modified radical hysterectomy) (Fig. 1) are as follows: step 1: preparation of lateral, ventral, and dorsal spaces (three steps); step 2: management of the uterine artery and of the parauterine lymphovascular tissue; step 3: unroofing of the ureter, division of the vesicouterine ligaments, and mobilization of the bladder base; step 4: division of the rectovaginal ligaments; and step 5: division of the paracervix at the ureter.

Results

The B2 variant, characterized by adding a lateral paracervical lymph node dissection, and the recently described parauterine lymphovascular tissue (PULT)3,4 resection, will be also featured. Here are the steps for additional paracervical lymphadenectomy: step 1: separation from the obturator nerve; step 2: separation from the paravesical tissue; step 3: removing the ventral component of the paracervix (lateral “parametrium”); step 4: removing the dorsal component of the paracervix (internal iliac nodes); and step 5: removing the lateral component of the paracervix (presciatic nodes).

Conclusions

In this video, we analyzed the surgical technique for type B radical hysterectomy, focusing on dissection of the uterus and lymph nodes, including the PULT. This highlights the importance of maintaining standardization of the procedure throughout the generations of gynecologic oncologists.