Laparoscopic or open pelvic and para-aortic lymphadenectomy

Why is a Laparoscopic or open pelvic and para-aortic lymphadenectomy offered?

While lymphadenectomy is not part of the staging for cervical cancer, it can provide prognostic information. Pelvic and para-aortic lymphadenectomy can be performed via a laparotomy or laparoscopy.

Removal of pelvic/para-aortic lymph nodes or glands (lymphadenectomy) is usually carried out as part of an operation to manage your gynaecological cancers (cervix, uterus and ovary), depending on the pre operative examination findings as well as the findings on images (USS, MRI, CT or PET-CT). Your doctor will usually go through this with you carefully.

Usually, if you are having an operation done laparoscopically or with the robot, the lymph glands can also be removed at the same time without needing a big cut on your tummy. However, in certain situations, especially when you have a large ovarian mass that is suspected to be cancerous, your doctor may advise you to have a midline cut on your tummy so that the mass can be removed intact.

This way, the risk of rupture of the ovarian mass/cyst is minimised and reduces the risk of spreading the disease. This could be quite significant for an early stage ovarian cancer, where, if the lymph nodes (pelvic and para-aortic) are uninvolved, and the cyst is removed intact, you can avoid having chemotherapy afterwards providing there is no other site of tumour spread.

Again, your gynaecology oncologist will go through all of this with you and make sure that you have all of the information that you need.