Personalized and Precision Medicine Journal
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Advancements in Hysterectomy for Women's Cancers: A Comprehensive Review of Emerging Surgical Techniques and Clinical Results

Document Type : Review Article

Authors

Hananeh Habib 1
Samira Abdollahi 2

1 1- Department of Obstetrics, Medical Faculty, Iran University of Medical Sciences, Tehran, Iran

2 Department of Obstetrics, Medical Faculty, Iran University of Medical Sciences, Tehran, Iran.

https://doi.org/10.22034/pmj.2025.2058666.1059
Abstract
Hysterectomy, the surgical excision of the uterus, has historically been fundamental in the management of gynecologic malignancies, encompassing endometrial, cervical, and ovarian cancers. Traditionally, hysterectomy has been executed via open abdominal surgery, a method that, although efficacious, frequently leads to extended recovery periods, heightened risk of complications, and greater psychological and physical strain for patients. In recent decades, substantial breakthroughs in surgical techniques and technology have fundamentally transformed the approach to these treatments, resulting in enhanced clinical outcomes, diminished complications, and expedited recovery periods. This study examines recent advancements in hysterectomy techniques, particularly highlighting the rise of minimally invasive approaches, including laparoscopic, robotic-assisted, and vaginal hysterectomy. These methods, characterized by smaller incisions and improved vision, are linked to many benefits, such as less blood loss, abbreviated hospital stays, and expedited resumption of normal activities. Furthermore, we examine the technical innovations that have significantly enhanced surgical precision, including 3D imaging, intraoperative molecular imaging, and real-time navigation systems.
These innovations have not only enhanced the effectiveness of treatment but have also contributed to a better overall quality of life for patients by reducing postoperative pain, minimizing scarring, and offering quicker recovery. Moreover, the psychological and emotional strains associated with cancer surgery, such as anxiety and body image concerns, are mitigated by less invasive techniques, resulting in enhanced patient satisfaction. Through this comprehensive analysis, the review highlights the transformative role of these technological and surgical advancements in gynecologic cancer treatment. These advancements enhance the precision and results of hysterectomy, reducing the long-term physical and psychological difficulties typically linked to cancer procedures, ultimately leading to improved treatment experiences and increased survival rates.

Keywords

Hysterectomy
Gynecologic cancers
Cervical cancer
Robotic-assisted hysterectomy
Surgical precision

Subjects

1.Zhu B, Gu H, Mao Z, Beeraka NM, Zhao X, Anand MP, et al. Global burden of gynaecological cancers in 2022 and projections to 2050. Journal of global health. 2024;14:04155.
2.Bassette E, Ducie JA. Endometrial Cancer in Reproductive-Aged Females: Etiology and Pathogenesis. Biomedicines. 2024;12(4).
3.Brooks RA, Fleming GF, Lastra RR, Lee NK, Moroney JW, Son CH, et al. Current recommendations and recent progress in endometrial cancer. CA: a cancer journal for clinicians. 2019;69(4):258-79.
4.Bianchi T, Grassi T, Bazzurini L, Di Martino G, Negri S, Fruscio R, et al. Radical Hysterectomy in Early-Stage Cervical Cancer: Abandoning the One-Fits-All Concept. Journal of personalized medicine. 2023;13(9).
5.Chou B, Prasad Venkatesulu B, Coleman RL, Harkenrider M, Small Jr W. Management of stage I and II cervical cancer: a review. International Journal of Gynecological Cancer. 2022;32(3):216-24.
6.Amarin ZO. Hysterectomy: Past, Present and Future. In: Amarin ZO, editor. Hysterectomy - Past, Present and Future. Rijeka: IntechOpen; 2022.
7.Zhang W, Jiang H, Wu G, Huang P, Wang H, An H, et al. The pathogenesis and potential therapeutic targets in sepsis. MedComm. 2023;4(6):e418.
8.Boggi U, Vistoli F, Amorese G. Twenty years of robotic surgery: a challenge for human limits. Updates in surgery. 2021;73(3):789-93.
9.Reddy K, Gharde P, Tayade H, Patil M, Reddy LS, Surya D. Advancements in Robotic Surgery: A Comprehensive Overview of Current Utilizations and Upcoming Frontiers. Cureus. 2023;15(12):e50415.
10.Yurtkal A, Canday M. Optimizing Hysterectomy: A Prospective Comparative Analysis of Surgical Techniques and Their Impact on Women’s Lives. Journal of personalized medicine [Internet]. 2024; 14(3).
11.30th International Congress of the European Association for Endoscopic Surgery (EAES) Kraków, Poland, 5–8 July 2022. Surgical Endoscopy. 2023;37(1):1-204.
12.Chakraborty N, Rhodes S, Luchristt D, Bretschneider CE, Sheyn D. Is total laparoscopic hysterectomy with longer operative time associated with a decreased benefit compared with total abdominal hysterectomy? American journal of obstetrics and gynecology. 2023;228(2):205.e1-.e12.
13.Levy L, Tsaltas J. Recent advances in benign gynecological laparoscopic surgery. Faculty reviews. 2021;10:60.
14.Rivero-Moreno Y, Echevarria S, Vidal-Valderrama C, Pianetti L, Cordova-Guilarte J, Navarro-Gonzalez J, et al. Robotic Surgery: A Comprehensive Review of the Literature and Current Trends. Cureus. 2023;15(7):e42370.
15.Ashrafian H, Clancy O, Grover V, Darzi A. The evolution of robotic surgery: surgical and anaesthetic aspects. British Journal of Anaesthesia. 2017;119:i72-i84.
16.Picozzi P, Nocco U, Labate C, Gambini I, Puleo G, Silvi F, et al. Advances in Robotic Surgery: A Review of New Surgical Platforms. Electronics [Internet]. 2024; 13(23).
17.Kalata S, Thumma JR, Norton EC, Dimick JB, Sheetz KH. Comparative Safety of Robotic-Assisted vs Laparoscopic Cholecystectomy. JAMA Surgery. 2023;158(12):1303-10.
18.Łajczak P, Janiec J, Żerdziński K, Jóźwik K, Nowakowski P, Nawrat Z. M.D. meets machine: the symbiotic future of surgical learning. European Surgery. 2024;56(5):131-42.
19.Muppala H, Rafi J, Najia SK. Laparoscopic-assisted vaginal hysterectomy for endometrial cancer in high body mass index (BMI) patients: a report of six cases. Gynecological Surgery. 2009;6(2):119-23.
20.Meriwether KV, Antosh DD, Olivera CK, Kim-Fine S, Balk EM, Murphy M, et al. Uterine preservation vs hysterectomy in pelvic organ prolapse surgery: a systematic review with meta-analysis and clinical practice guidelines. American journal of obstetrics and gynecology. 2018;219(2):129-46.e2.
21.Patel N, Chaudhari K, Jyotsna G, Joshi JS. Surgical Frontiers: A Comparative Review of Robotics Versus Laparoscopy in Gynecological Interventions. Cureus. 2023;15(11):e49752.
22.Cai Z, Zhang K, Li L, Suo Y. Application of 3D reconstruction and 3D printing technology in advanced ovarian cancer surgery: a retrospective study. Frontiers in oncology. 2024;14:1432970.
23.Zhang J, Liu X, Huang Y, Kong L, Su M, Hu Z. 3D reconstructed models based on real cervical cancer cases for undergraduate gynecological oncology education: a pre- and post-test study. 3D Printing in Medicine. 2025;11(1):7.
24.Kanbergs A, Melamed A, Viveros-Carreño D, Wu CF, Wilke RN, Zamorano A, et al. Surgical Deescalation Within Gynecologic Oncology. JAMA network open. 2025;8(1):e2453604.
25.Alaimo L, Marchese A, Vignola D, Roman D, Conci S, De Bellis M, et al. The Role of Three-Dimensional Modeling to Improve Comprehension of Liver Anatomy and Tumor Characteristics for Medical Students and Surgical Residents. Journal of Surgical Education. 2024;81(4):597-606.
26.Meyer-Szary J, Luis MS, Mikulski S, Patel A, Schulz F, Tretiakow D, et al. The Role of 3D Printing in Planning Complex Medical Procedures and Training of Medical Professionals-Cross-Sectional Multispecialty Review. International journal of environmental research and public health. 2022;19(6).
27.Liu Y, Wu X, Sang Y, Zhao C, Wang Y, Shi B, et al. Evolution of Surgical Robot Systems Enhanced by Artificial Intelligence: A Review. Advanced Intelligent Systems. 2024;6(5):2300268.
28.Hou Y, Tang J. Advantages of Using 3D Intraoperative Ultrasound and Intraoperative MRI in Glioma Surgery. Frontiers in oncology. 2022;12:925371.
29.Pulumati A, Pulumati A, Dwarakanath BS, Verma A, Papineni RVL. Technological advancements in cancer diagnostics: Improvements and limitations. Cancer reports (Hoboken, NJ). 2023;6(2):e1764.
30.Zhang J, Liu X, Huang Y, Kong L, Su M, Hu Z. 3D reconstructed models based on real cervical cancer cases for undergraduate gynecological oncology education: a pre- and post-test study. 3D Print Med. 2025;11(1):7.
31.Alkatout I, O’Sullivan O, Peters G, Maass N. Expanding Robotic-Assisted Surgery in Gynecology Using the Potential of an Advanced Robotic System. Medicina [Internet]. 2024; 60(1).
32.Portnoy Y, Koren J, Khoury A, Factor S, Dadia S, Ran Y, et al. Three-dimensional technologies in presurgical planning of bone surgeries: current evidence and future perspectives. International journal of surgery (London, England). 2023;109(1):3-10.
33.Liu Z, Ali M, Sun Q, Zhang Q, Wei C, Wang Y, et al. Current status and future trends of real-time imaging in gastric cancer surgery: A literature review. Heliyon. 2024;10(16):e36143.
34.Riddle EW, Kewalramani D, Narayan M, Jones DB. Surgical Simulation: Virtual Reality to Artificial Intelligence. Current Problems in Surgery. 2024;61(11):101625.
35.Restaino S, De Giorgio MR, Pellecchia G, Arcieri M, Vasta FM, Fedele C, et al. Artificial Intelligence in Gynecological Oncology from Diagnosis to Surgery. Cancers [Internet]. 2025; 17(7).
36.Privitera L, Paraboschi I, Cross K, Giuliani S. Above and Beyond Robotic Surgery and 3D Modelling in Paediatric Cancer Surgery. Frontiers in pediatrics. 2021;9:777840.
37.Azari F, Zhang K, Kennedy GT, Chang A, Nadeem B, Delikatny EJ, et al. Precision Surgery Guided by Intraoperative Molecular Imaging. Journal of nuclear medicine : official publication, Society of Nuclear Medicine. 2022;63(11):1620-7.
38.Pinto-Coelho L. How Artificial Intelligence Is Shaping Medical Imaging Technology: A Survey of Innovations and Applications. Bioengineering (Basel, Switzerland). 2023;10(12).
39.Schiliro C, Firestein BL. Mechanisms of Metabolic Reprogramming in Cancer Cells Supporting Enhanced Growth and Proliferation. Cells. 2021;10(5).
40.Wang B, Hu S, Teng Y, Chen J, Wang H, Xu Y, et al. Current advance of nanotechnology in diagnosis and treatment for malignant tumors. Signal Transduction and Targeted Therapy. 2024;9(1):200.
41.Bi WL, Hosny A, Schabath MB, Giger ML, Birkbak NJ, Mehrtash A, et al. Artificial intelligence in cancer imaging: Clinical challenges and applications. CA: a cancer journal for clinicians. 2019;69(2):127-57.
42.Centini G, Schettini G, Pieri E, Giorgi M, Lazzeri L, Martire FG, et al. Endometriosis-Related Ovarian Cancer: Where Are We Now? A Narrative Review towards a Pragmatic Approach. Journal of Clinical Medicine [Internet]. 2024; 13(7).
43.Lengyel E. Ovarian cancer development and metastasis. The American journal of pathology. 2010;177(3):1053-64.
44.Azari F, Kennedy GT, Zhang K, Bernstein E, Maki RG, Gaughan C, et al. Impact of Intraoperative Molecular Imaging after Fluorescent-Guided Pulmonary Metastasectomy for Sarcoma. Journal of the American College of Surgeons. 2022;234(5):748-58.
45.Teng F, Yu H, Wang B, Yan Y, Gao C, Guo F, et al. Patterns of lymph node metastases and their implications in individualized radiotherapeutic clinical target volume delineation of regional lymph nodes in patients with endometrial cancer. Journal of Cancer. 2022;13(14):3575-83.
46.Fumagalli D, De Vitis LA, Caruso G, Occhiali T, Palmieri E, Guillot BE, et al. Low-Volume Metastases in Apparent Early-Stage Endometrial Cancer: Prevalence, Clinical Significance, and Future Perspectives. Cancers (Basel). 2024;16(7).
47.Birge O, Bakir MS, Dogan S, Tuncer HA, Simsek T. The Relationship Between Parametrial Involvement and Parametrial Tissue Removed in Radical Surgery in Early-Stage Cervical Cancer. World journal of oncology. 2022;13(2):59-68.
48.Eissa A, Sighinolfi MC, Elsodany I, Habib G, Puliatti S, Zoeir A, et al. Robotic Pelvic Lymphadenectomy in Gynecological and Urological Malignancies. 2023;50(6).
49.Azari F, Kennedy G, Bernstein E, Hadjipanayis C, Vahrmeijer A, Smith B, et al. Intraoperative molecular imaging clinical trials: a review of 2020 conference proceedings. Journal of biomedical optics. 2021;26(5).
50.Yeung TL, Leung CS, Yip KP, Au Yeung CL, Wong ST, Mok SC. Cellular and molecular processes in ovarian cancer metastasis. A Review in the Theme: Cell and Molecular Processes in Cancer Metastasis. American journal of physiology Cell physiology. 2015;309(7):C444-56.
51.Vahrmeijer AL, Hutteman M, van der Vorst JR, van de Velde CJH, Frangioni JV. Image-guided cancer surgery using near-infrared fluorescence. Nature Reviews Clinical Oncology. 2013;10(9):507-18.
52.Scheenen TWJ, Zamecnik P. The Role of Magnetic Resonance Imaging in (Future) Cancer Staging: Note the Nodes. Investigative radiology. 2021;56(1):42-9.
53.Rony MKK, Kayesh I, Bala SD, Akter F, Parvin MR. Artificial intelligence in future nursing care: Exploring perspectives of nursing professionals - A descriptive qualitative study. Heliyon. 2024;10(4):e25718.
54.Yurtkal A, Canday M. Optimizing Hysterectomy: A Prospective Comparative Analysis of Surgical Techniques and Their Impact on Women’s Lives. Journal of personalized medicine. 2024;14(3).
55.Kim SI, Yoo JG, Lee SJ, Park DC, Yoon JH. Robot-assisted versus conventional laparoscopic radical hysterectomy in cervical cancer stage IB1. International Journal of Medical Sciences. 2023;20(3):287-91.
56.Argenta PA, Mattson J, Rivard CL, Luther E, Schefter A, Vogel RI. Robot-assisted versus laparoscopic minimally invasive surgery for the treatment of stage I endometrial cancer. Gynecologic oncology. 2022;165(2):347-52.
57.Ioana JT, Voiță-Mekereș F, Motofelea AC, Ciprian D, Fulger L, Alexandru I, et al. Surgical Outcomes in Laparoscopic Hysterectomy, Robotic-Assisted, and Laparoscopic-Assisted Vaginal Hysterectomy for Uterine and Cervical Cancers: A Systematic Review. Diagnostics [Internet]. 2024; 14(24).
58.Bartels HC, Rogers AC, Janda M, Obermair A, Brennan DJ. Quality of life following minimally invasive hysterectomy compared to abdominal hysterectomy: A metanalysis. European journal of obstetrics, gynecology, and reproductive biology. 2020;252:206-12.
59.Masucci M, Karlsson C, Blomqvist L, Ernberg I. Bridging the Divide: A Review on the Implementation of Personalized Cancer Medicine. Journal of personalized medicine [Internet]. 2024; 14(6).
60.Khiabani NA, Doustvandi MA, Story D, Nobari SA, Hajizadeh M, Petersen R, et al. Glioblastoma therapy: State of the field and future prospects. Life Sciences. 2024;359:123227.
61.McCarthy A, Samarakoon D, Gray J, Mcmeekin P, McCarthy S, Newton C, et al. Robotic and laparoscopic gynaecological surgery: a prospective multicentre observational cohort study and economic evaluation in England. 2023;13(9):e073990.
Personalized and Precision Medicine Journal
Volume 10, Issue 37 - Serial Number 37
Original article
Spring 2025
Pages 48-57

  • Receive Date 02 February 2025
  • Revise Date 23 April 2025
  • Accept Date 21 May 2025

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