Robot assisted/A laparoscopic radical hysterectomy

A laparoscopic / Robot assisted radical hysterectomy is a surgical procedure primarily used to treat early-stage cervical cancer or endometrial cancer. It involves removing the uterus, cervix, ovaries, part of the vagina, surrounding tissues and nearby lymph nodes. This procedure is less invasive than traditional open surgery, offering benefits such as quicker recovery times and reduced postoperative pain. Here’s an overview of the indications and technique:

Indications:

1. Early-stage cervical cancer: Laparoscopic radical hysterectomy is commonly recommended for stage IA2 to IIA cervical cancer or till stage 3 endometrial cancer.
2. Precancerous conditions: In some cases of severe cervical dysplasia (pre-cancerous changes in cervical cells), a radical hysterectomy may be recommended to prevent the progression to cervical cancer.
3. Small cervical tumors: For select cases of small cervical tumors, laparoscopic radical hysterectomy may be a treatment option.

Technique:

1. Preoperative Evaluation: Before the procedure, the patient undergoes a thorough evaluation, including imaging studies (such as MRI or CT scans) to assess the extent of the cancer and determine if laparoscopic surgery is appropriate.
2. Anesthesia: The patient is placed under general anesthesia to ensure they are unconscious and pain-free throughout the surgery.
3. Port Placement: Several small incisions (ports) are made in the abdomen, typically around the belly button and lower abdomen. These ports allow the surgeon to insert laparoscopic instruments and a camera (laparoscope) into the abdomen.
4. Insufflation: Carbon dioxide gas is pumped into the abdomen to create space and improve visibility for the surgeon.
5. Dissection and Mobilization: Using specialized instruments, the surgeon carefully separates the uterus, cervix, and surrounding tissues from the pelvic wall and adjacent structures. The blood vessels supplying these structures are carefully identified and either tied off or sealed to minimize bleeding.
6. Lymph Node Dissection: The surgeon may also perform a lymph node dissection to remove lymph nodes from the pelvic area. This helps determine if the cancer has spread beyond the cervix and aids in staging.
7. Specimen Removal: Once the necessary tissues are dissected and removed, they are placed in a specimen bag and extracted through one of the abdominal ports.
8. Closure: The remaining tissues are carefully inspected for any bleeding, and the incisions are closed with sutures or surgical staples.
9. Postoperative Care: After the procedure, the patient is monitored closely in the recovery room and typically spends a few days in the hospital for observation. Pain management, physical activity, and other postoperative instructions are provided to promote healing and recovery.