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Patients underwent Kyoto B2 radical hysterectomy with pelvic lymphadenectomy via simultaneous vaginal and abdominal routes (open or laparoscopic), while pneumovaginoscopy created a vaginal cuff and supported paracolpium/paracervical fascia dissection to minimize nerve injury. Among 59 patients, microscopic R0 was achieved in all, median follow-up was 44.5 months, and no recurrence occurred.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/pneumovaginoscopy-assisted-radical-hysterectomy-for-early-stage-cervical-cancer-a-novel-bidirectional-approach-for-tumor-spillage-prevention-and-r0-resection/406303/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/pneumovaginoscopy-assisted-radical-hysterectomy-for-early-stage-cervical-cancer-a-novel-bidirectional-approach-for-tumor-spillage-prevention-and-r0-resection/406303.png","ImageObject",300,407,{"name":42,"@type":43},"Aran","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-05","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",14,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What is pneumovaginoscopy-assisted radical hysterectomy (PVRH) in this study?","Question",{"text":63,"@type":64},"PVRH is a bidirectional (vaginal and abdominal) fascia-oriented and nerve-sparing radical hysterectomy technique. Pneumovaginoscopy is used to create a vaginal cuff and to help dissect relevant pelvic fascia to reduce nerve damage.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How was the operation performed and what surgical approach was used?",{"text":68,"@type":64},"Patients received Kyoto B2 radical hysterectomy and pelvic lymphadenectomy through simultaneous vaginal and abdominal approaches (open or laparoscopic). Pneumovaginoscopy supported dissection around the paracolpium and paracervical endopelvic fascia.",{"name":70,"@type":61,"acceptedAnswer":71},"What outcomes were reported regarding margin status and recurrence?",{"text":72,"@type":64},"Microscopic R0 was achieved in all cases. During a median follow-up of 44.5 months, no recurrence was observed.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},406303,1790810507,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":55,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145,"preview_page_count":4},137455076865,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","J Gynecol Oncol. 2023 Nov;34(6):e80 [https://doi.org/10.3802/jgo.2023.34.e80](https://doi.org/10.3802/jgo.2023.34.e80)[ ](https://doi.org/10.3802/jgo.2023.34.e80)pISSN 2005-0380·eISSN 2005-0399  \nOriginal Article  \nReceived: Jan 30, 2023  \nRevised: Jun 15, 2023  \nAccepted: Jun 24, 2023  \nPublished online: Jul 6, 2023  \nCorrespondence to  \nMasato Kita  \nDepartment of Obstetrics and Gynecology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka 573-1010, Japan.  \nEmail: [kitamas@hirakata.kmu.ac.jp](kitamas@hirakata.kmu.ac.jp)  \n© 2023. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology  \nThis is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ([https://](https://)[ ](https://)[creativecommons.org/licenses/by-nc/4.0/](creativecommons.org/licenses/by-nc/4.0/)) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.  \nORCID iDs  \nMasato Kita  [https://orcid.org/0000-0002-0986-5495](https://orcid.org/0000-0002-0986-5495)[ ](https://orcid.org/0000-0002-0986-5495)Yusuke Butsuhara  [https://orcid.org/0000-0002-4948-9869](https://orcid.org/0000-0002-4948-9869)[ ](https://orcid.org/0000-0002-4948-9869)Yoji Hisamatsu  [https://orcid.org/0000-0002-8872-4972](https://orcid.org/0000-0002-8872-4972)[ ](https://orcid.org/0000-0002-8872-4972)Takuya Yokoe  [https://orcid.org/0000-0001-8506-0464](https://orcid.org/0000-0001-8506-0464)[ ](https://orcid.org/0000-0001-8506-0464)Hidetaka Okada  [https://orcid.org/0000-0002-7932-6999](https://orcid.org/0000-0002-7932-6999)  \nPneumovaginoscopy-assisted radical hysterectomy for early-stage cervical cancer: a novel bidirectional approach for tumor spillage prevention and R0 resection  \nMasato Kita , Yusuke Butsuhara , Yoji Hisamatsu , Takuya Yokoe , Hidetaka Okada   \nDepartment of Obstetrics and Gynecology, Kansai Medical University, Hirakata, Japan  \nABSTRACT  \nObjective: This study evaluated the feasibility and outcomes of pneumovaginoscopy-assisted radical hysterectomy (PVRH) for cervical cancer up to stage IIA using a bidirectional fasciaoriented and nerve-sparing surgical approach.  \nMethods: This retrospective observational cohort study examined the operative outcomesand prognoses of patients who underwent PVRH (n=59) for up to stage IIA cervical cancer. The basic procedure was Kyoto B2 (Viper Type II nerve-sparing) radical hysterectomy and pelvic lymphadenectomy through simultaneous vaginal and abdominal (open or laparoscopic) approaches. In all cases, pneumovaginoscopy (PV) was used to create a vaginal cuff and dissect the paracolpium and paracervical endopelvic fascia to minimize nerve damage.  \nResults: Thirty-eight (64.4%) patients had stage IB1 cancer. Seven (11.9%) had vaginal invasion (stage IIA1, n=4; IIA2, n=3) . The abdominal approach was open in 38 cases and laparoscopic in 21. Adjuvant therapy was administered to 24 patients (41%); one patient received concurrent chemoradiotherapy for gastric-type adenocarcinoma. There were three (6.1%) intraoperative complications (CO2 gas embolism [n=1], sigmoid colon musculosa injury [n=1], and ureteral injury [n=1]) and 8 (14%) postoperative complications (lymphedema with cellulitis [n=4], vaginal cuff dehiscence [n=1], sub-ileus [n=1], symptomatic lymphocyst [n=l], and ureterovaginal fistula [n=1]) . The median urination recovery period was 3 days. Microscopic R0 was achieved in all cases. The median follow-up was 44.5 (2–122) months, and no recurrence occurred.  \nConclusion: PVRH is a new fascia-oriented and nerve-sparing surgery for early-stage cervical cancer. Further, it has favorable operative outcomes and good prognoses, similar to those of adjacent pelvic surgery such as trans-anal total mesorectal excision and radical prostatectomy.  \nKeywords: Cervical Cancer; Hysterectomy; Natural Orifice Transluminal Endoscopic Surge","cbCaiuvrAnwUG8fc","https://ap.wps.com/l/cbCaiuvrAnwUG8fc","pdf",13950318,"English","# Abstract\n# Synopsis\n# Introduction","[{\"question\":\"What is pneumovaginoscopy-assisted radical hysterectomy (PVRH) in this study?\",\"answer\":\"PVRH is a bidirectional (vaginal and abdominal) fascia-oriented and nerve-sparing radical hysterectomy technique. Pneumovaginoscopy is used to create a vaginal cuff and to help dissect relevant pelvic fascia to reduce nerve damage.\"},{\"question\":\"How was the operation performed and what surgical approach was used?\",\"answer\":\"Patients received Kyoto B2 radical hysterectomy and pelvic lymphadenectomy through simultaneous vaginal and abdominal approaches (open or laparoscopic). Pneumovaginoscopy supported dissection around the paracolpium and paracervical endopelvic fascia.\"},{\"question\":\"What outcomes were reported regarding margin status and recurrence?\",\"answer\":\"Microscopic R0 was achieved in all cases. During a median follow-up of 44.5 months, no recurrence was observed.\"}]","Pneumovaginoscopy-assisted radical hysterectomy for early-stage cervical cancer - a novel bidirectional approach for tumor spillage prevention and R0 resection | PDF",1790564737,35]