Skip to main content

Laparoscopic Radical Hysterectomy for Malignant Indications: Laparoscopic Trachelectomy

  • Chapter
  • First Online:
Hysterectomy

Abstract

Radical hysterectomy with lymph node dissection represents the standard treatment for early-stage cervical cancer, alternative surgical approaches able to spare reproductive organs have been developed. In this context, vaginal radical trachelectomy (VRT) with laparoscopic lymphadenectomy represents the gold standard for fertility sparing surgery in early stage cervical cancer patients. In selected cases laparoscopic radical trachelectomy (LRT) may offer specific advantages. In this manuscript, we report a literature review and describe this surgical approach step by step.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 229.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 299.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 449.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90.

    Article  PubMed  Google Scholar 

  2. Rebecca S, Elizabeth W, Otis B, et al. Cancer statistics, 2011: the impact of eliminating socioeconomic and radical disparities on premature cancer death. CA Cancer J Clin. 2011;61:212–36.

    Article  Google Scholar 

  3. Covens A, Rosen B, Murphy J, et al. Changes in the demographics and perioperative care of stage IA(2)/IB(1) cervical cancer over the past 16 years. Gynecol Oncol. 2001;81:133–7.

    Article  CAS  PubMed  Google Scholar 

  4. Dargent D, Brun L, Roy M. Trachelectomy broaden. An alternative to radical hysterectomy in the treatment of invasive cancers developed on the outer surface of the uterine cervix [in French]. J Obstet Gynecol. 1994;2:292–5.

    Google Scholar 

  5. Pareja R, Rendon GJ, Sanz-Lomana CM, Monzon O, Ramirez PT. Surgical, oncological, and obstetrical outcomes after abdominal radical trachelectomy – a systematic literature review. Gynecol Oncol. 2013;131:77–82.

    Article  PubMed  Google Scholar 

  6. Diaz JP, Sonoda Y, Leitao MM, Zivanovic O, Brown CL, Chi DS, et al. Oncologic outcome of fertility-sparing radical trachelectomy versus radical hysterectomy for stage IB1 cervical carcinoma. Gynecol Oncol. 2008;111:255–60.

    Article  PubMed  Google Scholar 

  7. Höckel M, Horn LC, Manthey N, Braumann UD, Wolf U, Teichmann G, Frauenschläger K, Dornhöfer N, Einenkel J. Resection of the embryologically defined uterovaginal (Müllerian) compartment and pelvic control in patients with cervical cancer: a prospective analysis. Lancet Oncol. 2009 Jul;10(7):683–92.

    Article  PubMed  Google Scholar 

  8. Chiantera V, Vizzielli G, Lucidi A, Gallotta V, Petrillo M, Legge F, Fagotti A, Sehouli J, Scambia G, Muallem MZ. Laparoscopic radical hysterectomy in cervical cancer as total mesometrial resection (L-TMMR): a multicentric experience. Gynecol Oncol. 2015;139(1):47–51. pii: S0090-8258(15)30071-8.

    Article  CAS  PubMed  Google Scholar 

  9. Vercellino GF, Piek JM, Schneider A, Köhler C, Mangler M, Speiser D, Chiantera V. Laparoscopic lymph node dissection should be performed before fertility preserving treatment of patients with cervical cancer. Gynecol Oncol. 2012;126(3):325–9.

    Article  PubMed  Google Scholar 

  10. Pareja R, Rendón GJ, Vasquez M, Echeverri L, Sanz-Lomana CM, Ramirez PT. Immediate radical trachelectomy versus neoadjuvant chemotherapy followed by conservative surgery for patients with stage IB1 cervical cancer with tumors 2 cm or larger: a literature review and analysis of oncological and obstetrical outcomes. Gynecol Oncol. 2015;137(3):574–80.

    Article  PubMed  Google Scholar 

  11. Schneider A, Köhler C. Locoregional recurrence after laparoscopic radical trachelectomy: the vaginal cuff must be closed to avoid tumor cell contamination of the peritoneal cavity. Int J Gynecol Cancer. 2015;25(4):550.

    Article  PubMed  Google Scholar 

  12. Lee CL, Huang KG, Wang CJ, et al. Laparoscopic radical trachelectomy for stage Ib1 cervical cancer. J Am Assoc Gynecol Laparosc. 2003;10:11–115.

    Article  Google Scholar 

  13. Cibula D, Ungar L, Palfalvi L, et al. Laparoscopic abdominal radical trachelectomy. Gynecol Oncol. 2005;97:707–9.

    Article  CAS  PubMed  Google Scholar 

  14. Park NY, Chong GO, Cho YL, et al. Total laparoscopic nerve-sparing radical trachelectomy. J Laparoendosc Adv Surg Tech. 2009;19:53–8.

    Article  Google Scholar 

  15. Park JY, Kim DY, Suh DS, et al. Reproductive outcomes after laparoscopic radical trachelectomy for early-stage cervical cancer. J Gynecol Oncol. 2014;25:9–13.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Martin A, Torrent A. Laparoscopic nerve-sparing radical trachelectomy: surgical technique and outcome. J Minim Invasive Gynecol. 2010;17:37–41.

    Article  PubMed  Google Scholar 

  17. Lu Q, Zhang Y, Liu C, et al. Total laparoscopic radical trachelectomy in the treatment of early squamous cell cervical cancer: a retrospective study with 8-year follow-up. Gynecol Oncol. 2013;130:275–9.

    Article  PubMed  Google Scholar 

  18. Ebisawa K, Takano M, Fukuda M, et al. Obstetrics outcomes of patients undergoing total laparoscopic radical trachelectomy for early stage cervical cancer. Gynecol Oncol. 2013;131:83–6.

    Article  PubMed  Google Scholar 

  19. Kucukmetin A, Biliatis I, Ratnavelu N, et al. Laparoscopic radical trachelectomy is an alternative to laparotomy with improved perioperative outcomes in patients with early-stage cervical cancer. Int J Gynecol Cancer. 2014;24:135–40.

    Article  PubMed  Google Scholar 

  20. Martinez A, Poilblanc M, Ferron G, et al. Fertility-preserving, surgical procedures, techniques. Best Pract Res Clin Obstet Gynecol. 2012;26:407–24.

    Article  Google Scholar 

  21. Geisler JP, Orr CJ, Manahan KJ. Robotically assisted total laparoscopic radical trachelectomy for fertility sparing in stage IB1 adenosarcoma of the cervix. J Laparoendosc Adv Surg Tech A. 2008;18:727–9.

    Article  PubMed  Google Scholar 

  22. Regan L, Braude PR, Trembath PL. Influence of past reproductive performance on risk of spontaneous abortion. BMJ. 1989;299:541–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Preterm birth. In: Cunningham FG, Gant NF, Leveno KJ, et al., editors. Williams obstetrics. 21st ed. New York: McGraw-Hill; 2001. p. 689–727.

    Google Scholar 

  24. Querleu D. Laparoscopic radical hysterectomy. Am J Obstet Gynecol. 1993;168:1643–5.

    Article  CAS  PubMed  Google Scholar 

  25. Gottschalk E, Lanowska M, Chiantera V, Marnitz S, Schneider A, Brink-Spalink V, Hasenbein K, Koehler C. Vaginal-assisted laparoscopic radical hysterectomy: rationale, technique, results. JSLS. 2011;15(4):451–9.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Koehler C, Gottschalk E, Chiantera V, Marnitz S, Hasenbein K, Schneider A. From laparoscopic assisted radical vaginal hysterectomy to vaginal assisted laparoscopic radical hysterectomy. BJOG. 2012;119(2):254–62.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Vito Chiantera .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Chiantera, V., Lucidi, A., Petrillo, M. (2018). Laparoscopic Radical Hysterectomy for Malignant Indications: Laparoscopic Trachelectomy. In: Alkatout, I., Mettler, L. (eds) Hysterectomy. Springer, Cham. https://doi.org/10.1007/978-3-319-22497-8_44

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-22497-8_44

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-22496-1

  • Online ISBN: 978-3-319-22497-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics