Presenter of 1 Presentation
SINGLE-SITE LAPAROSCOPIC RADICAL TRACHELECTOMY WITHOUT A UTERINE MANIPULATOR
Abstract
Introduction
Report regarding single-site laparoscopic radical trachelectomy (RT) is still absent at the present stage, for which the feasibility and safety of this surgery remains a question. We herein introduce the single-site laparoscopic RT without a uterine manipulator for a nulligravida patient with early-stage cervical cancer to preserve fertility without compromising the oncology outcomes.
Description
A 29-year-old woman who was diagnosed with stage IB1 (FIGO 2018) cervical cancer underwent the single-site laparoscopic (RT) plus pelvic lymphadenectomy without the manipulator. We used our expertise with single-site laparoscopic technique to perform space development as much as possible before the ligaments were resected. First, the bilateral round ligaments were sutured to form a coil, and the uterus was suspended by sutures from different directions according to the different operative requirements. Second, prior to colpotomy, a vagino-purse-string suture was formed to avoid spreading of tumor cells. The operative time was 300 minutes, and blood loss was 20 mL. No perioperative complications occurred and the residual cervix and vagina were restored to its original anatomy after 6 months. Postoperative pathological results suggested that the patient did not need radiotherapy or chemotherapy. So far, the surgical scar becomes invisible and the patient has resumed normal menstruation and sexual life.
Conclusion/Implications
Single-site laparoscopic RT plus pelvic lymphadenectomy without the manipulator should be deemed as a safe and feasible therapeutic option for patients with early-stage cervical cancer for fertility preservation. More cases shall be in place to better evaluate the postoperative efficacy and pregnancy outcomes of such procedure to a further step.