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The Swift operation: a modification of the Leiden nerve-sparing radical hysterectomy

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Gynecological Surgery

Abstract

In 2002, our group introduced an operation to avoid damage to the pelvic autonomous nerves during radical hysterectomy that proved to be feasible, effective and safe. During the last five years, we have adapted our surgical technique to make this procedure easier and safer in terms of radicality. We report on the changes in the surgical approach and the results in the first 15 consecutive patients. The Swift operation is more radical in the area of the uterosacral ligaments than the original operation, and it dissects the hypogastric nerve free under direct vision. In the area of the parametria, it is more radical in the deep lateral part. The vascular parametrial tissue is dissected and separated ventrally from the ureters. From October 2006 to February 2007, 15 consecutive patients with cervical cancer stage IA2 to IB2 underwent the Swift operation. The extra operating time amounted to 20 min, which was similar to the original operation, and with no extra blood loss. The suprapubic catheter was removed after a median of five days. Up until now (February 2008), no recurrences have been seen in these patients. It was concluded that the Swift procedure is easy to perform and that it offers advantages over the original operation in terms of safety and radicality.

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Authors and Affiliations

  1. Department of Gynecology, Leiden University Medical Center, P.O. Box 9600, Leiden, 2300RC, The Netherlands

    J. B. Trimbos, S. A. H. M. van den Tillaart, C. P. Maas, A. A. W. Peters, K. N. Gaarenstroom & G. G. Kenter

  2. Department of Anatomy and Embryology, Leiden University Medical Center, Leiden, The Netherlands

    M. C. DeRuiter

Authors
  1. J. B. Trimbos
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  2. S. A. H. M. van den Tillaart
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  3. C. P. Maas
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  4. A. A. W. Peters
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  5. K. N. Gaarenstroom
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  6. M. C. DeRuiter
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  7. G. G. Kenter
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Correspondence to J. B. Trimbos.

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Trimbos, J.B., van den Tillaart, S.A.H.M., Maas, C.P. et al. The Swift operation: a modification of the Leiden nerve-sparing radical hysterectomy. Gynecol Surg 5, 193–198 (2008). https://doi.org/10.1007/s10397-008-0382-1

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  • DOI: https://doi.org/10.1007/s10397-008-0382-1

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