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. 2015 Jan-Mar;19(1):e2013.00248.
doi: 10.4293/JSLS.2013.00248.

Laparoscopic radical trachelectomy: technique, feasibility, and outcomes

José Martín Saadi  1 , Myriam Perrotta  1 , Roberto Orti  1 , Gloria Salvo  1 , María Eugenia Giavedoni  1 , Sebastían Gogorza  1 , Roberto Testa  1
Affiliations

Laparoscopic radical trachelectomy: technique, feasibility, and outcomes

José Martín Saadi et al. JSLS. 2015 Jan-Mar.

Abstract

Background and objectives: Our objectives are to describe our surgical technique for laparoscopic radical trachelectomy, to evaluate its feasibility, and to present the perioperative results at Hospital Italiano de Buenos Aires, Argentina.

Methods: We analyzed 4 patients who underwent laparoscopic radical trachelectomy for early-stage cervical cancer between December 2011 and May 2013.

Results: Four patients were included in this study. Total laparoscopic radical trachelectomy was performed in all cases. The mean age was 26 years (range, 19-32 years), the mean body mass index was 21 (range, 18-23), and the mean length of hospital stay was 33 hours (range, 24-36 hours). The mean operative time was 225 minutes (range, 210-240 minutes), and no complications were reported. During the postoperative period, only 1 patient presented with left vulvar edema, which resolved spontaneously. The pelvic and parametrial lymph nodes, as well as the vaginal cuff and cervical resection margins, were negative for malignancy in all cases. On average, 18 pelvic lymph nodes (range, 15-20) were removed. The tumor stage was IB in all 4 patients, and the mean tumor size was 17 mm (range, 12-31 mm). No patient required conversion to laparotomy.

Conclusion: We consider laparoscopic radical trachelectomy, performed by trained surgeons, a feasible and safe therapeutic option as a fertility-sparing surgical technique, with good perioperative outcomes for women with early-stage cervical cancer with a desire to preserve their fertility. Minimally invasive surgery provides the widely known benefits of this type of approach.

Keywords: Cervical cancer; Laparoscopy; Trachelectomy.

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Figures

Figure 1.
Figure 1.
Trocar placement.
Figure 2.
Figure 2.
Opening of paravesical and pararectal space.
Figure 3.
Figure 3.
Preservation of left uterine artery and ureteral dissection.
Figure 4.
Figure 4.
The ureter is separated up to its insertion into the bladder.
Figure 5.
Figure 5.
Resection of parametria meeting radicality criteria.
Figure 6.
Figure 6.
Cervical amputation 2 cm above cervicovaginal junction.
Figure 7.
Figure 7.
Intrauterine catheter.
Figure 8.
Figure 8.
Reanastomosed uterus with absorbable suture.
Figure 9.
Figure 9.
Specimen.
See this image and copyright information in PMC

References

    1. Dargent D, Brun JL, Roy M, Mathevet P, Remy I. La trachelectomie elargie (TE), une alternative a l'hysterectomie radical dans le traitment des cancers infiltrants developpes sur la face externe du col uterin. J Obstet Gynecol. 1994;2:285–292.
    1. Covens AL, Shaw P. Is radical trachelectomy a safe alternative to radical hysterectomy for early stage IB carcinomas of the cervix? Gynecol Oncol. 1999;72:443–444. - PubMed
    1. Shepherd JH, Milliken DA. Conservative surgery for carcinoma of the cervix. Clin Oncol. 2008;20:395–400. - PubMed
    1. Smith JR, Boyle DC, Corless DJ, et al. Abdominal radical trachelectomy: a new surgical technique for the conservative management of cervical carcinoma. Br J Obstet Gynaecol. 1997;104(10):1196–2000. - PubMed
    1. Ungár L, Pálfalvi L, Hogg R, et al. Abdominal radical trachelectomy: a fertility-preserving option for women with early cervical cancer. BJOG. 2005;112:366–369. - PubMed