Robotic Radical Trachelectomy for Post-Hysterectomy Cervical Cancer

Case

A 49-year-old woman from Central India, with a BMI of 28, presented with vaginal bleeding 20 days after an abdominal subtotal hysterectomy. Examination revealed a growth on the cervix, and a biopsy confirmed cervical cancer.

Detailed investigations, including PET-CT and pelvic MRI, showed no parametrial involvement but suggested equivocal lymph node status.

The Approach

The patient underwent a Robotic Radical Completion Trachelectomy with the following procedures:

• Bilateral Pelvic Lymphadenectomy
• Omentectomy
• Para-aortic Lymph Node Sampling

Intraoperative ultrastaging revealed negative pelvic node status, aligning the clinical and pathological staging. This approach addressed the incomplete staging from the prior subtotal hysterectomy.

As a prophylactic measure, the patient was advised to undergo adjuvant chemotherapy (CT) and external beam radiation therapy (EBRT), given the incomplete staging during her initial surgery.

The Outcome

The patient responded well to the treatment, showing no evidence of illness for 10 months. She remains on regular follow-up, demonstrating the effectiveness of a robotic-assisted surgical approach in managing post-hysterectomy cervical cancer.