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On Demand Hall
LAPAROENDOSCOPIC RADICAL TRACHELECTOMY AND PELVIC LYMPHADENECTOMY WITHOUT UTERINE MANIPULATOR (ID 65)
Abstract
Abstract Body
Introduction: In face of the postponement in marital and reproductive age in the modern society, most of the patients with cervical cancer have not conceived yet or still bear fertility plans. We herein introduce the Laparoendoscopic radical trachelectomy (LRT) a surgery called radical trachelectomy through a minimally invasive approach for young patients with cervical cancer to preserve fertility without compromising the oncology outcomes.
Description : A 29-year-old, nulliparous woman with stage IB1 cervical cancer received the LRT plus lymphadenectomy with enclosed colpotomy and without manipulator. Instead of using a uterine manipulator, uterine suspension was adopted. We suture bilateral round ligaments to form a coil with the anterior wall of the uterus which help remain the integrity of the uterus. After the branches of the uterine artery were separated, the uterine branch was retained.Reconstruction of the residual cervix and vagina was performed by the "cuff-sleeve" suture method. The anterior and posterior walls of the vagina were sutured with 2 "U" shapes respectively with special care given to the uterine branches of the uterine artery. At the end of the surgery, a stent was set trans-vaginally in case of cervical stenosis. The “neocervix” was restored to its original anatomy after 6 months.Till now, reproductive function and sexual health is satisfied for the patient.
Conclusions: LRT with unique modifications is safe and feasible for patients with early stage cervical cancer to preserve fertility. Further study shall be in place to better evaluate the postoperative efficacy and pregnancy outcomes of such procedure.