Fertility sparing key-hole procedures

Understanding your treatment options.

Helping you to understand

At Gynae Solution, we will use plain language to explain what you have, what the treatment options are and what your prognosis is in terms you can understand.

Fertility sparing key-hole procedures for cervical cancer

A trachelectomy is a type of surgery that removes the cervix. It is used for early stage cervical cancer. 

Trachelectomy is sometimes called a fertility sparing surgery. This is because it does not remove the womb (uterus), meaning it may be possible to become pregnant in the future. 

Research has shown that trachelectomy is just as effective at removing cervical cancer as another type of surgery called hysterectomy. 

Listening to you

It's important to find a consultant who will listen to your concerns to help explain and answer any questions you might have.

Are there different types of trachelectomy?

Yes there are 3 different types available:

Radical trachelectomy

A radical trachelectomy removes:

  • the cervix
  • the tissue around the womb (parametrium)
  • part of the upper vagina.

A simple trachelectomy

This procedure only removes the cervix. It does not remove the tissue around your womb, called the parametrium, or part of the upper vagina.

Lymph node removal

Sometimes the lymph nodes in your pelvis are also removed during trachelectomy. Removing the lymph nodes is called a lymphadenectomy.

Who is suitable for a trachelectomy?

Trachelectomy is an effective treatment for early stage cervical cancer. It is usually suggested for cervical cancers that measure 2cm or less.  This normally means stages 1A1, 1A2 or 1B1, as long as the cervical cancer has not spread to your lymph nodes.      

A trachelectomy is not available in all hospitals and not all gynaecologists offer this procedure. Mr Jaf Abu has a specialist interest in trachelectomy procedures. 

How is a trachelectomy performed?

Having  a trachelectomy for cervical cancer involves tests to check you and fit and well for surgery, deciding how the trachelectomy will be done, and having the surgery.  

A trachelectomy can be done in different ways. It is important to talk to your surgeon about how your trachelectomy will be done before the surgery. They can explain any risks and benefits of each option, including how it might affect the time it takes to recover.

Vaginal trachelectomy

In a vaginal trachelectomy, your surgeon removes the cancer through a cut that is made in the top of the vagina. 

Research suggests there is a slightly higher risk that not all of the cervical cancer will be removed using vaginal trachelectomy. This may mean you need to have further treatment, which could impact your fertility. However, vaginal trachelectomy may also have fewer side effects and better results for preserving fertility.  

Vaginal trachelectomy is sometimes done laparoscopically.

Laparoscopic or key hole trachelectomy

Your surgeon does the operation through small cuts (key holes) in your abdomen. They will use tools that have a tiny camera attached, so that they can see the inside of your body on a screen.  

In some hospitals, a robot will assist the surgeon. The surgeon is in the same room but sits away from you and controls the robotic arms to perform the surgery. It allows the surgeon to make more controlled and precise movements. The surgeon is still the one doing the surgery. This is sometimes called robotic trachelectomy. 

Recovery after keyhole surgery is usually faster because there is less blood loss. This means your hospital stay may be shorter.

Abdominal trachelectomy

In an abdominal trachelectomy, your surgeon will make an opening either along your bikini line or running down from your belly button. They will remove the cervical cancer through this opening. 

An abdominal trachelectomy might be more suitable for you if you have a larger cervical cancer, because the surgeon is more likely to remove all of the cancer. However, some research suggests that there might a lower chance of getting pregnant in the future. You may also have a longer recovery time.


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