A novel technique for the management of the vesicouterine ligament during radical hysterectomy

Abstract Objective To introduce a simple and safe method for the management of the vesicouterine ligament (VUL) during radical hysterectomy. Method From 2004 to 2006, 35 patients with the International Federation of Gynecology and Obstetrics (FIGO) stage IB1 ( n = 32) and IB2 ( n = 3) invasive cervical cancer underwent radical hysterectomy. Epinephrine, which was diluted 1:1,000,000 times with saline solution, was injected into the VUL. We investigated whether this hydrodissection technique is safe and simple to apply in the management of the VUL during radical hysterectomy. Result The hydrodissection technique enabled us to easily identify cervicovesical vessels. As a result, none of the patients suffered ureteral injury during radical hysterectomy. Conclusion The injection of diluted epinephrine into the VUL is safe and simple to apply in the management of the VUL during radical hysterectomy.