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.

Asset Subtitle

Recorded on March 4, 2026

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