Abstract
<title>Abstract</title> <p>Background Cervical cancer remains the most common gynecological malignancy. Radical hysterectomy is the standard treatment for early-stage cervical cancer, the complex neurovascular anatomy of the ureteral tunnel often leads to intraoperative bleeding or ureteral injury. This study evaluates the "Dual-Bridge" technique, a novel ureter-centric approach designed to simplify ureteral tunnel dissection through two interconnected anatomical windows. Methods In this retrospective cohort study, we analyzed 197 patients with FIGO stage IB or IIA cervical cancer who underwent laparoscopic radical hysterectomy between May 2023 and May 2025. Patients were divided into the Dual-bridge group (n = 104) and the conventional group (n = 93). Primary outcomes included operative time, intraoperative blood loss, and surgical complications. Results The Dual-bridge group showed a significantly shorter total operative time (189.35 ± 33.27 vs. 221.22 ± 37.80 min, p < 0.01) and a reduced duration for uterine artery and vesicouterine ligament dissection (41.73 ± 7.60 vs. 50.90 ± 8.79 min, p < 0.01). Furthermore, intraoperative blood loss was significantly lower in the Dual-bridge group compared to the conventional group (107.12 ± 66.75 vs. 129.35 ± 66.39 mL, p < 0.01). There were no significant differences in urological or other surgical complications between the two groups. Conclusion The Dual-bridge technique offers a safe and efficient approach for managing the ureteral tunnel during laparoscopic radical hysterectomy. By utilizing natural anatomical planes, this method minimizes blood loss and enhances surgical efficiency without compromising oncological safety or increasing the risk of ureteral injury.</p>