Fig. 5. Comparison of various method of hysterectomy. The hysterectomy used for cervical cancer in Japan is defined by the extent of 4 directions of the tissue surrounding the cervix: three components of the parametrium/paracervix and the paracolpium. Type C2 surgery in Querleu-Morrow classification is equivalent to the Okabayashi radical hysterectomy if it removes the PSNs in the lateral parametrial excision.

IHP, inferior hypogastric plexus; PLND, pelvic lymphadenectomy; PSN, pelvic splanchnic nerve; RH, radical hysterectomy.