Laparoendoscopic single-site radical hysterectomy with pelvic lymphadenectomy: initial multi-institutional experience for treatment of invasive cervical cancer.

To describe the feasibility, safety and outcomes of women with stage I cervical cancer treated with laparoendoscopic single-site surgery radical hysterectomy (LESS-RH).A retrospective descriptive study (III).Multiple academic teaching hospitals.Women with FIGO stage IA1-IB1 cervical cancer.LESS-RH as primary therapy for cervical cancer performed by a gynecologic oncologist with expertise in LESS. A multichannel, single-port access device, a flexible-tipped 5-mm laparoscope, and a multifunctional instrument were used in all cases. Clincopathologic, surgical and perioperative outcomes were analyzed.Twenty-two women were identified in whom a LESS-RH was attempted; 20 (91\%) successfully underwent the procedure, including 19 wherein pelvic lymphadenectomy (PLND) was completed. Of the two converted procedures, one patient underwent two-port laparoscopy secondary to truncal obesity and one patient underwent conversion to laparotomy secondary to external iliac vein laceration during PLND. Median age and BMI were 46 years and 23.3 kg/m2, respectively. Median number of pelvic lymph nodes removed was 22. One patient experienced an intraoperative complication, and no patient required reoperation. Margins of excision were negative. One patient with two positive pelvic nodes and one patient with microscopic parametrial disease received adjuvant chemosensitized radiation; 3 additional patients received adjuvant radiation therapy secondary to an intermediate risk for recurrence. After a median follow up of 11 months, no recurrences were detected.LESS-RH/PLND is feasible and safe for select patients with stage I cervical cancer. Larger studies are needed to confirm whether the increased technical difficulty of this procedure justifies its use in routine gynecologic oncology practice.