Features of laparoscopic adnexectomy and extirpation of the cervical stump after subtotal hysterectomy

Serhij Yu. Vdovychenko, Oleksandr V Zabudskyi
In: Perinatology and reproductology from research to practice · 2026 · vol. 6(3) , pp. 111 · doi:10.52705/2788-6190-2026-03-11 · W7214749368
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This study analyzed ten cases of laposcopic adnexectomy and cervical stump extirpation following subtotal hysterectomy, detailing a surgical algorithm for managing associated pathologies such as ovarian tumors with endometriosis.

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This study analyzed ten cases of patients undergoing laparoscopic adnexectomy and cervical stump extirpation following a prior subtotal hysterectomy. Preoperative diagnoses included benign ovarian tumors combined with cervical stump endometriosis in thirty percent of the patients, alongside recurrent polyps, leukoplakia, and cervical myoma. The authors detailed a specific surgical algorithm involving the identification of anatomical structures, transection of ligaments, and mobilization of fascial planes to ensure safe specimen excision. Relevance to endometriosis: endometriosis of the cervical stump was explicitly identified as a preoperative condition in three of the ten patients studied.

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Abstract

Objective of the study. To study the features of laparoscopic adnexectomy and extirpation of the cervical stump after subtotal hysterectomy. Materials and methods. To achieve the set objective, 10 cases were analyzed where patients with benign ovarian tumors and pathology of the cervical stump after subtotal hysterectomy underwent bilateral adnexectomy and extirpation of the cervical stump. At the preoperative stage, the following conditions were diagnosed: ovarian tumors in combination with endometriosis of the cervical stump (3 patients – 30%); recurrent polyps (3 patients – 30%); leukoplakia (3 patients – 30%); myoma of the cervical stump (1 patient – 10%), diagnosed during the preoperative examination stage. Results. The stages of our technique for the extirpation of the cervical stump are defined as follows: search for anatomical structures; identification of the stumps of the round ligaments of the uterus and the suspensory ligaments of the ovary; transection of the ligaments and, if possible, creation of a "window"; opening and wide "separation" of the parametria; identification of the ureters; transection of the uterosacral ligaments; mobilization of the pubovesical fascia; transection of the vessels; incision of the fascia and excision of the specimen; suturing of the vaginal stump. Conclusions. The results of the conducted studies indicate that the scientific problem of ovarian tumors and cervical pathology after subtotal hysterectomy is highly important. The use of our proposed laparoscopic intervention algorithm will allow for timely diagnosis of this pathology and the performance of effective laparoscopic surgical intervention.
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Keywords

ovarian tumors, pathology of the cervical stump, subtotal hysterectomy, laparoscopic treatmentAbstract DOI: 10.52705/2788-6190-2026-03-11 УДК 618.11-006.03-089:18.14-089.87

Objective

of the study. To study the features of laparoscopic adnexectomy and extirpation of the cervical stump after subtotal hysterectomy.

Materials

and methods. To achieve the set objective, 10 cases were analyzed where patients with benign ovarian tumors and pathology of the cervical stump after subtotal hysterectomy underwent bilateral adnexectomy and extirpation of the cervical stump. At the preoperative stage, the following conditions were diagnosed: ovarian tumors in combination with endometriosis of the cervical stump (3 patients – 30%); recurrent polyps (3 patients – 30%); leukoplakia (3 patients – 30%); myoma of the cervical stump (1 patient – 10%), diagnosed during the preoperative examination stage. Results. The stages of our technique for the extirpation of the cervical stump are defined as follows: search for anatomical structures; identification of the stumps of the round ligaments of the uterus and the suspensory ligaments of the ovary; transection of the ligaments and, if possible, creation of a "window"; opening and wide "separation" of the parametria; identification of the ureters; transection of the uterosacral ligaments; mobilization of the pubovesical fascia; transection of the vessels; incision of the fascia and excision of the specimen; suturing of the vaginal stump. Conclusions. The results of the conducted studies indicate that the scientific problem of ovarian tumors and cervical pathology after subtotal hysterectomy is highly important. The use of our proposed laparoscopic intervention algorithm will allow for timely diagnosis of this pathology and the performance of effective laparoscopic surgical intervention. Downloads Published How to Cite Issue Section License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

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