{
  "abstract": "Cervical cancer remains the fourth most common cancer among women globally and the second leading cause of cancer-related deaths. Radical hysterectomy (RH), combined with bilateral pelvic lymphadenectomy, is the recommended treatment for early-stage cervical cancer. The Laparoscopic Approach to Cervical Cancer (LACC) trial revealed inferior oncological outcomes with minimally invasive surgery (MIS) compared with open surgery, prompting many professional societies to recommend laparotomy as the standard approach. However, the relatively recent development of MIS and the lack of standardised protocols during the LACC trial suggest that dismissing MIS entirely may be premature. MIS techniques face challenges in achieving optimal radical resection, particularly in defining and standardising the dissection of sub-peritoneal avascular spaces. Advances in embryologically based anatomical surgeries, such as total mesometrial resection (TMMR), have shown promise but require reproducible anatomical markers and refined dissection methods to become practical and widely adopted.Recent anatomical studies have identified natural pelvic spaces and vascular landmarks, providing a foundation for standardised TMMR. Techniques such as uterine manipulator-free surgery have been introduced to improve MIS outcomes. Despite concerns raised by the LACC trial, MIS continues to evolve, offering benefits such as reduced bleeding, faster recovery and enhanced visualisation. By leveraging high-definition laparoscopy and adhering to tumour-free principles, MIS for cervical cancer can achieve improved oncological outcomes while maintaining functional preservation, marking a new phase of innovation and refinement in cervical cancer surgery.",
  "authors": [
    {
      "affiliations": [
        "Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, Zhejiang, China",
        "Department of Gynecology, Women’s Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China"
      ],
      "name": "Yinluan Ouyang"
    },
    {
      "affiliations": [
        "Department of Gynecology, Yuncheng Central Hospital, Yuncheng, Shanxi, China"
      ],
      "name": "Weiqin Lv"
    },
    {
      "affiliations": [
        "Department of Gynecology, Guiyang Maternal and Child Health Care Hospital, Guiyang, China"
      ],
      "name": "Juntao Wang"
    },
    {
      "affiliations": [
        "Department of Obstetrics and Gynecology, Fujian Medical University, Fuzhou, China"
      ],
      "name": "Xinqin He"
    },
    {
      "affiliations": [
        "Department of Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen, China"
      ],
      "name": "Jianfa Lan"
    },
    {
      "affiliations": [
        "Department of Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen, China"
      ],
      "name": "Qionghua Chen"
    },
    {
      "affiliations": [
        "Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, Zhejiang, China",
        "Department of Gynecology, Women’s Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China"
      ],
      "name": "Xiaofeng Zhao"
    }
  ],
  "title": "LACC trial: not the end of minimally invasive radical hysterectomy, but a new beginning",
  "uid": "93c33d5d-ef29-5560-973c-63227cd0b785"
}