Renaissance der Operation nach Schauta

100 years of radical vaginal hysterectomy according to Schauta is an occasion to evaluate the value of this “forgotten” surgical technique. The possibility of laparoscopic removal of paraaortic and pelvic lymph nodes in patients with cervical cancer opened the way for the reintroduction of “Schauta's operation”. In a curative approach to primary tumors lymphonodectomy is performed laparoscopically. In presence of negative lymph nodes and if bladder and rectum are free of disease laparoscopic assisted radical vaginal hysterectomy is performed. A combination of laparoscopic and vaginal surgical techniques permits individualized, risk-adjusted approaches to cervical carcinoma. Even in cases of large tumors, a nerve-sparing approach to radical vaginal hysterectomy results in maintenance of motoric bladder function with high surgical radicality and locoregional safety. It is possible to surgically treat early tumor states by laparoscopically assisted radical trachelectomy to preserve fertility when oncological standards are observed. At present, the laparoscopically assisted radical vaginal hysterectomy and the well-established abdominal Wertheim operation represent two oncologically equivalent surgical procedures available for treatment of early cervical carcinoma.