IGCS Ramadan Nights-Session #2

Video Transcription

Video Summary

The second session of the IGCS “Ramadan Nights” online education series brought together gynecologic oncology clinicians across the region during a difficult period, emphasizing collaboration and continued learning. Co-chairs Basri Revki (Egypt/Bahrain) and David Attala (Lebanon) introduced a program featuring a surgical anatomy film and a journal discussion focused on cervical cancer surgery.<br /><br />Ilker Seljuk (Turkey) presented a laparoscopic retroperitoneal dissection video, reviewing key pelvic sidewall landmarks and stepwise “layer-by-layer” dissection. He highlighted identification and protection of critical structures including the ureter, iliac vessels, obturator nerve, genitofemoral and femoral nerves, and autonomic nerves (superior/inferior hypogastric plexus, hypogastric nerves, pelvic splanchnic nerves). Practical cautions included careful energy use near nerves, understanding venous bleeding risks (e.g., deep uterine/vaginal venous plexus), and recognizing spaces (paravesical/pararectal) and parametrial components relevant to radical hysterectomy and nerve-sparing techniques.<br /><br />Panel commentary stressed simplifying pelvic anatomy for trainees using consistent landmarks (ureter and umbilical artery) and prioritizing fascial planes to enable bloodless, functional surgery—especially important in oncology and endometriosis.<br /><br />The journal segment reviewed evidence on minimally invasive surgery (MIS) for early-stage cervical cancer. Speakers summarized the LACC trial and subsequent analyses showing worse disease-free and overall survival with MIS radical hysterectomy, reinforcing open surgery as the current guideline standard outside trials. They discussed factors potentially influencing outcomes—tumor size (<2 cm), conization prior to surgery, avoiding uterine manipulators, and protective vaginal cuff closure—alongside observational data (e.g., SUCCOR) and de-escalation trials (CONSERVE, SHAPE) suggesting selected low-risk patients may safely undergo less radical surgery, with ongoing trials expected to clarify MIS’s role. The session concluded with a reminder that patient selection, expert imaging/pathology, and nodal assessment are central, and that IGCS will continue the series next week.

Keywords

IGCS Ramadan Nights

gynecologic oncology education

laparoscopic retroperitoneal dissection

pelvic sidewall anatomy

nerve-sparing radical hysterectomy

ureter and iliac vessel identification

paravesical and pararectal spaces

autonomic pelvic nerves hypogastric plexus

minimally invasive surgery cervical cancer

LACC trial radical hysterectomy outcomes

cervical cancer de-escalation trials SHAPE CONSERVE