Advancements in Robotic Surgery for Radical Stump Trachelectomy
Minimally invasive robotic surgery for a radical stump trachelectomy offers hope to patients experiencing uterine cancer in their cervix following a supracervical hysterectomy. Moffitt’s gynecologic oncology program provides expertise in treating this rarity, using advanced tools and techniques to give patients the best possible outcome.
Supracervical Hysterectomy and Potential Recurrence of Uterine Cancer in the Remaining Cervix
Supracervical hysterectomy is a partial hysterectomy that allows the lower part of the cervix, known as the cervical “stump,” to remain intact.
While this surgery approach can benefit many patients, those who undergo a supracervical hysterectomy still face a risk of disease recurrence that may require further treatment, including a potential trachelectomy to remove the remaining cervix. The risk of cervical stump carcinoma after supracervical hysterectomy is 2-5%, accounting for 1.6-4.4% of all cervical cancers.
Patients need to understand what kind of hysterectomy they have. If it was a supracervical hysterectomy and the lower cervix was left intact, it’s critical to continue routine pelvic exams and a strict annual cancer screening to ensure early detection of any evolving cancer in the small area of remaining cervical tissue.
Following a supracervical hysterectomy, symptoms of recurring cancer may arise several months to years later, with any interval time between the hysterectomy and trachelectomy.
Innovative Robotic Surgery for Radical Stump Trachelectomy
When patients experience cervical symptoms (such as chronic pelvic pain, vaginal bleeding, impaired sexuality, or an abnormal pap smear) after a supracervical hysterectomy and oncologists confirm that uterine cancer has developed in the retained cervix, a radical stump trachelectomy may be necessary. This procedure removes the cervix and any affected surrounding tissue that may include the parametria, uterosacral ligaments, and upper vagina.
In the past, most radical stump trachelectomy surgeries were open. Then, a laparoscopic approach emerged as a minimally invasive option. However, there were challenges, including a 2-dimensional view and limited dexterity.
Robotic surgery allows surgeons to overcome these technical challenges of laparoscopy, allowing for a 3-dimensional view, improved ergonomics, and intuitive motion while maintaining a minimally invasive approach.
Now, skilled minimally invasive surgeons use these robotic platforms and tools when performing radical stump hysterectomies to take advantage of their many benefits, including increased precision, instrument articulation, downscaled movement, and filtered hand tremors. It also reduces surgeon postural fatigue – and with a long surgery such as this one, improving the surgeon’s experience can improve patient results.
This robotic approach to radical stump trachelectomy is a valuable means of achieving safe and reproducible outcomes. Moffitt is proud to offer this innovative surgery as an option to our patients who experience the rarity of uterine cancer in a remaining cervix after undergoing a partial hysterectomy.
Robotic Radical Stump Trachelectomy Presentation. Watch the video
How Moffitt Stands Out
Surgical expertise in using innovative robotics to achieve successful outcomes of this complex and minimally invasive procedure is critical. Moffitt’s team of surgeons comprises many experts in this field, including Dr. Monica Avila, a gynecologic oncologist specializing in complex surgical approaches such as this minimally invasive robotic technique.
Moffitt also utilizes the latest technology of ICG dye to detect sentinel lymph nodes and ureters.
While the development of uterine cancer in a remaining cervix is rare, patients who find themselves in this position can have peace of mind that Moffitt has the understanding, expertise, and skill to treat it with a range of options. By working collaboratively, our multi-specialty cancer care teams ensure each patient receives the best care possible with a treatment plan unique to their cancer.
Referring providers with patients experiencing cancer in the cervix following a supracervical hysterectomy can reach out to Moffitt at any time. We’re happy to answer questions and refer providers and their patients to the correct department to become an established Moffitt patient and begin discussing potential treatment options.
If you'd like to refer a patient to Moffitt Cancer Center, complete our online form or contact a physician liaison for assistance. As part of our efforts to shorten referral times as much as possible, online referrals are typically responded to within 24 - 48 hours.
