One of the priorities for our team of gynecologic oncologists, who also perform surgery, is to provide minimally invasive surgical options for patients, including robotic surgery, laparoscopic procedures, and fertility-sparing surgeries. The benefits of these types of surgeries include
- Less pain
- Faster recovery, which means an earlier return to your normal activity levels and less time away from work
- Shorter hospital stays (typically overnight rather than several nights)
- Decreased blood loss
Our physicians are careful about recommending certain types of surgeries. The success of a surgery will depend on many complicated factors. Therefore, not every surgery will be right for every patient.
A cancer diagnosis is a devastating blow for anyone. However, for a woman who wishes to have children, the diagnosis of a gynecologic cancer can strike extra hard. Many of the treatment options available to combat the cancer can have a negative effect on a woman's fertility. The good news is that with advances in the field of fertility-sparing surgeries, a woman with gynecologic cancer may still be able to have children in the future.
The key factor in fertility-sparing surgery is how advanced the cancer is, which is often not known until the surgery. Your surgeon will discuss your surgical options with you prior to the surgery. It is important that you discuss your wish to have children with your doctors.
If the cervical cancer is advanced, but still limited to the cervix, a trachelectomy may be a surgical option for you.
The procedure removes the cervix and the upper part of the vagina, leaving the uterus in place. It can preserve your fertility, though there are extra steps you need to take during your subsequent pregnancy.
Normally, the cervix acts as a "gate" during pregnancy, keeping the fetus safe in the uterus. Because your cervix was removed, your surgeon will make a small stitch at the bottom of the uterus, to act as a replacement for the cervix, and help keep the pregnancy inside your uterus. Pregnancy following a trachelectomy does carry a higher risk for miscarriage or a premature birth. You would also require a caesarean section to deliver the baby.
Pelvic Reconstructive Surgery
Following treatment for gynecologic cancer, a woman may require pelvic reconstructive surgery. The goal of this procedure is to restore anatomy and function of the pelvic area. Not only can this surgery reduce problems and side effects from cancer treatments, but it can also improve your quality of life.
Pelvic reconstructive surgery may consist of creating a new vagina, bladder, or pelvic floor in a manner that is both functional and aesthetically pleasing. It includes the following specific procedures:
- A prolapsed pelvis occurs when the muscles inside your pelvis weaken, making it difficult for them to support your pelvic organs (the vagina, uterus, bladder, and bowel). The organs then begin to fall and shift against each other. Reconstruction of the pelvic floor recreates that support and may treat urinary or rectal incontinence.
- Recurrent cervical cancer exenteration is an extreme type of surgery, in which all of the organs of the pelvis, including the bladder and rectum, are removed. The bladder and vagina are rebuilt from the patient's own tissues. This procedure is performed on women who have recurrent cervical cancer. (Recurrent cancer is cancer that keeps coming back, even after treatment.)