The Interventional Procedures Advisory Committee (IPAC) will consider this procedure review and NICE will issue an interventional procedures consultation document about its safety and efficacy for 4 weeks’ public consultation. IPAC will then review the consultation document in the light of comments received and produce a final interventional procedures document, which will be considered by NICE before guidance is issued to the NHS in England, Wales, Scotland and Northern Ireland.
 
 
Status In progress
Process IP
ID number 51
Description Minimally invasive radical hysterectomy for early stage cervical cancer is done using general anaesthesia. A uterine manipulator is inserted through the vagina, and attached to the uterus and cervix. The abdomen is insufflated with carbon dioxide, and several small incisions are made to provide access for the laparoscope and surgical instruments. A robot may be used to assist with the procedure. A hysterectomy is done by dividing the round ligaments, accessing the broad ligaments, dividing the uterine vessels and mobilising the uterus out of its peritoneal coverings by dividing the uterosacral ligaments. If the ovaries are to be left in position, the utero-ovarian ligaments are transected. The pelvic lymph nodes and sometimes the para-aortic lymph nodes are removed through 1 of the abdominal incisions or through the vagina. The upper vagina, cervix and uterus are removed through the vagina. The technique is distinct from laparoscopically assisted vaginal hysterectomy, which combines laparoscopic division of the infundibulopelvic ligaments and the uterine vessels, before a vaginal hysterectomy is done. A nerve-sparing radical hysterectomy is a modified technique that preserves pelvic nerves to prevent bladder dysfunction. The aim is to remove all the cancer. The suggested benefits of the laparoscopic approach are shorter length of stay in hospital, shorter recovery period and minimal abdominal scarring.

Provisional Schedule

Interventional procedure consultation 25 June 2020 - 23 July 2020
Expected publication 16 December 2020

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For further information on how we develop guidance, please see our page about NICE interventional procedures guidance