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Throughout the world’s gynecological circles, the definition of radical hysterectomy (RH) remains ambiguous. In the West, the Wertheim or modified Wertheim procedure is principally carried out (Ramirez et al. 2018; Plante et al. 2024), whereas in East Asia, RH is centered on a modified Okabayashi procedure, that is, preservation of the lateral rectal ligament and vesical nerve branches (Yabuki et al. 1991, 1996, 2000; Yabuki 1997). The differences between the two principal surgical procedures in these geographical zones are primarily one of excision or non-excision of the deep uterine vein and its surrounding connective tissue and whether or not the vesical nerve branches are intentionally preserved.

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Introduction

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  • 发表日期：

    2025年

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  • Yoshihiko Yabuki

摘要

Throughout the world’s gynecological circles, the definition of radical hysterectomy (RH) remains ambiguous. In the West, the Wertheim or modified Wertheim procedure is principally carried out (Ramirez et al. 2018; Plante et al. 2024), whereas in East Asia, RH is centered on a modified Okabayashi procedure, that is, preservation of the lateral rectal ligament and vesical nerve branches (Yabuki et al. 1991, 1996, 2000; Yabuki 1997). The differences between the two principal surgical procedures in these geographical zones are primarily one of excision or non-excision of the deep uterine vein and its surrounding connective tissue and whether or not the vesical nerve branches are intentionally preserved.