Characteristics of the author’s RH procedure involve preservation of the bladder and rectal function with non-excision of the lateral rectal ligament. For this, the following is carried out: (a) perpendicular excavation of the paravesical space, Latzko’s pararectal space, fourth space, and Okabayashi’s pararectal space and (b) excision of (i) SS, or a complex consisting of the vesicohypogastric fascia, TCL, and lateral rectal ligament, (ii) the mesoureter that is separated into anterior and posterior parts, and (iii) the suspensory system consisting of the uterosacral and vesicouterine ligaments, all of which are selectively separated by the creation of the perpendicularly created spaces. All photographs in this chapter were taken during surgery unless otherwise stated.