Trachelectomy is derived from the word ‘trachelos’ meaning the neck and refers to surgical removal of the neck of the uterus (the womb) in a woman. The neck of the uterus is the cervix and hence the procedure is also referred to as Cervicectomy. A trachelectomy procedure is indicated when a cervical cancer of early stages is suspected. Cervical cancer is the second most common cancer in women and the main modality of treating any type of cancer is a surgery followed by chemotherapy or radiotherapy. Trachelectomy is a more conservative procedure when compared to hysterectomy as it preserves the uterus and helps young women in conceiving a child in future.
When is trachelectomy surgery indicated?
Trachelectomy is indicated in women who are affected with early stages of cervical cancer and the size of the cancerous tissue is not more than 2-3 cm in size. Trachelectomy is a rather smaller surgery as compared to a traditional hysterectomy surgery where the entire uterus along with the cervix is removed. Trachelectomy is mainly indicated in younger women who are affected with cervical cancer and wish to have children in the future.
When is trachelectomy surgery not advised?
Trachelectomy is not advised in later stages of cervical cancer when the cancer has started invading the adjacent tissues as removal of only the cervix can leave some cancerous tissue behind leaving to further progression of cancer.
How do you know if trachelectomy surgery is indicated for you?
If you are experiencing a growth in your genitourinary area which is symptomatic causing pain, discomfort and bleeding, it is advised to consult a specialist preferably a gynecologist to approach to a diagnosis. The consulting doctor will conduct a routine physical examination and analyze your symptoms and would also conduct a CT or MRI scan to see the extent of cancerous tissue to help in staging of cancer. Sometimes the doctor might also conduct a small biopsy to see if the tissue in the growth is cancerous or not. The doctor will advise you to undergo a trachelectomy procedure after appropriate analysis of your condition and understanding of risks and benefits of the procedure for you.
What are the types of trachelectomies ?
Depending upon the type of surgical approaches trachelectomy can be divided as;
- Vaginal radical trachelectomy surgery : The surgical approach is made through the vagina.
- Abdominal radical trachelectomy surgery: The surgical approach to remove the cervix is made via the lower abdomen.
- Laparoscopic radical trachelectomy surgery: This is a minimally invasive procedure which is performed using a laparoscope which is a thin tube like instrument fitted with a camera and a microscope passed in to cervix via two three small cuts in the lower abdomen.
Does the procedure require anesthesia?
Yes, trachelectomy is performed after administration of general anesthesia.
What happens during a trachelectomy surgery ?
The treating surgeon will make you lie on your back on the operating table with your legs spread apart on the operating table to gain better visibility and accessibility during the procedure. Any of the above mentioned surgical approaches can be used depending on patients overall health and analysis of risks and benefits of each procedure. The principle of a standard trachelectomy is based on the principle of surgical removal of the part of vagina and part of cervix whereas the uterus is left in its place. When only a part of vagina is removed the procedure is also called as simple trachelectomy. Sometimes the deep abdominal lymph nodes are also removed as a part of the radical trachelectomy surgery to prevent the spread of tumor.
As during the radical trachelectomy procedure a part of the cervix (the parametrial tissue) is removed the surgeon uses a stitches to close the opening of the uterus where the cervix used to be to aid in normal flow of blood during the menstrual cycle. Initially a catheter may be put in place to drain out blood and to prevent it from closing.
The tissue obtained during the surgical procedure is sent for microscopic laboratory examination to identify the cancer cells and to determine if any further treatment like chemotherapy, radiotherapy or a hysterectomy may be required.
What care has to be taken after the trachelectomy surgery ?
Since trachelectomy is a major surgical procedure the patient is monitored for about 4-7 days in the hospital for any postoperative complications and successful healing of the surgical would. The patient is advised to not engage in any strenuous exercises, sports, lifting of heavy weights, sexual activity or usage of tampons until advised by the treating specialist to avoid any potential complications. Routine follow ups with your doctor are important to check the status of surgical site and check for any recurrence of cancer. A special procedure to identify cancer like a pap smear or a colposcopy may be performed to identify any cancerous growth in the surgical site post operatively.
What are the risks and complications of trachelectomy surgery ?
Trachelectomy is a major surgical procedure hence complications like bleeding, clotting, infection and anesthesia related complications like nausea, vomiting, and abdominal discomfort could occur. Rare complications may include damage to the uterus, the bladder and fertility.
Can you get pregnant after trachelectomy surgery ?
Yes, trachelectomy is indicated in women who are affected with cervical cancer and are of child bearing age. Though trachelectomy is a major surgery hence the pregnancy may be a high risk pregnancy, it is possible to conceive and give birth after a trachelectomy procedure. If you want to get pregnant in future it is essential to ask the doctor in detail about the risks and benefits related to pregnancy in future post trachelectomy.
What is the outcome of trachelectomy surgery ?
Most women who are affected with early stages of cervical cancer and are in the reproductive age are suitable candidates for a trachelectomy procedure, but it is advised to consult a specialist and understand the risk, benefits and outcome of the procedure based on the individuals overall health. Trachelectomy is more conservative treatment than hysterectomy as it helps one in getting rid of cancer while preserving the child bearing ability. A complete physical examination guided by adjuncts like CT/MRI scan are essential to arrive at a diagnosis and plan the best possible treatment suitable for your symptoms and conditions for improve the overall prognosis.
How to find and reach gynecologists for trachelectomy surgery ?
Now you can find gynecologists for trachelectomy surgery from different hospitals and destinations on a single platform, Hinfoways. You can avail opinions from multiple gynecologists, get approximate cost of trachelectomy surgery from different hospitals, compare things and then choose a gynecologist for trachelectomy surgery. Find a gynecologist for trachelectomy surgery on Hinfoways. Make an informed choice.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
