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Cervical cancer surgery has a history of more than 100-years whereby it has transitioned from the open approach to minimally invasive surgery (MIS). From the era of clinical exploration and practice, minimally invasive gynecologic surgeons have never ceased to explore new frontiers in the field of gynecologic surgery. MIS has fewer postoperative complications, including reduction of treatment-related morbidity and length of hospital stay than laparotomy; this forms the mainstay of treatment for early-stage cervical cancer. However, in November 2018, the New England Journal of Medicine had published two clinical studies on cervical cancer surgery (Laparoscopic Approach to Cervical Cancer [LACC]). Following these publications, laparoscopic surgery for early-stage cervical cancer has come under intense scrutiny and negative perceptions. Many studies began to explore the concept of standardized surgery for early-stage cervical cancer. In this article, we performed a review of the history of cervical cancer surgery, outlined the standardization of cervical cancer surgery, and analyzed the current state of affairs revolving around cervical cancer surgery in the post-LACC era.

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Background: An in-depth knowledge of the vascular anatomy of the female pelvis is crucial for any gyneoncologic surgeon. No two patients are the same, hence it is possible to encounter anatomical variants while performing laparoscopic gyne-oncologic surgery. In this case, we would like to report a rare variant of obturator artery origin, arising as a Y-shaped trunk from the posterior division of the internal iliac artery. Case: A 58-year-old postmenopausal lady, with hypertension, degenerative disease of the knees, presented with abnormal uterine bleeding. Endometrial biopsy revealed atypical hyperplasia with grade 1 endometrioid carcinoma. Computed tomography scan showed an equivocal filling defect in the uterine cavity. Result: Patient underwent laparoscopic surgical staging with total hysterectomy, bilateral salpingo-oophorectomy, with bilateral pelvic lymphadenectomy for endometrial carcinoma. Surgeons encountered an unusual branching of obturator artery from the posterior division of internal iliac artery, resembling Y shape. Conclusion: Variants of obturator artery origin and anatomy is more common than thought, with reports in literatures ranging from 0.5% to 18% of cases. It is important to familiarize oneself with the variations as to avoid troublesome bleeding and complications during gyne-oncologic surgery.