{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T04:40:32Z","timestamp":1759725632284,"version":"build-2065373602"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The main objective of this study is to apply the tumor-free technique in robot-assisted radical hysterectomy to effectively prevent tumor exposure and dissemination during the operation. Meanwhile, this study aims to standardize and optimize this technique, thereby promoting its wide application in clinical practice and ensuring the stability and reproducibility of surgical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The surgical indications for this study were as follows: patients with stage IA2, IB1, IB2, IIA1, and certain specific pathological types of IB3 and IIA2 cervical cancer(FIGO 2018). During the operation, suture suspension of the uterus was used instead of a uterine manipulator. Before incising the vagina, the vaginal orifice was closed. After completing the vaginal closure, the vaginal wall was rinsed with 42\u00b0C sterile distilled water. All surgical procedures followed the concept of embryonic compartment-based hysterectomy according to membrane anatomy, ensuring the integrity of the M\u00fcllerian embryonic compartment\u2019s membrane structure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Guided by the concept of membrane anatomy, robot-assisted radical hysterectomy facilitates bloodless surgery while improving surgical efficiency and precision through the simplification and optimization of techniques. Moreover, this approach maintains the integrity of the M\u00fcllerian duct embryonic compartment, thus preventing tumor spillage. When integrated with tumor-free exposure techniques, it offers cervical cancer patients the advantages of minimally invasive surgery, including faster recovery, reduced surgical trauma, and a lower risk of iatrogenic tumor dissemination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Employing robotic technology in conjunction with the concept of membrane anatomy during radical hysterectomy can lead to a more meticulous and precise surgical outcome. The application of precise surgical techniques not only facilitates the standardization and optimization of procedures but also minimizes patient trauma and accelerates recovery.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2025.1598519","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T04:10:29Z","timestamp":1759723829000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Implementation of tumor-free and total M\u00fcllerian compartment resection techniques in robot-assisted radical hysterectomy: protocol for standardizing surgical procedures"],"prefix":"10.3389","volume":"15","author":[{"given":"Xinyou","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinming","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siman","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Na","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shichao","family":"Han","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs","article-title":"The mesorectum in rectal cancer surgery\u2013the clue to pelvic recurrence","volume":"69","author":"Heald","year":"1982","journal-title":"Br J Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1396","DOI":"10.1001\/archsurg.1992.01420120030005","article-title":"Potency, cure, and local control in the operative treatment of rectal cancer","volume":"127","author":"Enker","year":"1992","journal-title":"Arch Surg"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(05)70324-7","article-title":"Association between the mesenchymal compartment of uterovaginal organogenesis and local tumour spread in stage IB-IIB cervical carcinoma: a prospective study","volume":"6","author":"H\u00f6ckel","year":"2005","journal-title":"Lancet Oncol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2010.06.019","article-title":"Vulvar field resection: novel approach to the surgical treatment of vulvar cancer based on ontogenetic anatomy","volume":"119","author":"H\u00f6ckel","year":"2010","journal-title":"Gynecol Oncol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2011.04.040","article-title":"Ontogenetic anatomy of the distal vagina: relevance for local tumor spread and implications for cancer surgery","volume":"122","author":"H\u00f6ckel","year":"2011","journal-title":"Gynecol Oncol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"791","DOI":"10.1111\/j.1525-1438.2003.13608.x","article-title":"Total mesometrial resection: high resolution nerve-sparing radical hysterectomy based on developmentally defined surgical anatomy","volume":"13","author":"H\u00f6ckel","year":"2003","journal-title":"Int J Gynecol Cancer"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(09)70100-7","article-title":"Resection of the embryologically defined uterovaginal (M\u00fcllerian) compartment and pelvic control in patients with cervical cancer: a prospective analysis","volume":"10","author":"H\u00f6ckel","year":"2009","journal-title":"Lancet Oncol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2010.02.014","article-title":"Local spread of cervical cancer revisited: a clinical and pathological pattern analysis","volume":"117","author":"H\u00f6ckel","year":"2010","journal-title":"Gynecol Oncol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2007.07.049","article-title":"Do we need a new classification for radical hysterectomy? 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