Total laparoscopic radical hysterectomy and bilateral pelvic lymphadenectomy of cervical cancer stage IB – case report

Abstract

Objective: Clinical application of minimally invasive surgical techniques in gynecology continuous to increase steadily. Laparoscopic surgery has widely replaced open surgical technique in many routine cases. This method is obviously less traumatic and painful, requires a shorter hospital stay and recovery time. The aim of the study is to present the first operation of total laparoscopic radical hysterectomy and bilateral pelvic lymphadenectomy of cervical cancer. Patient and method: A 44-year-old woman was admitted to hospital for surgery due to cervical cancer stage IB1. The patient body mass index was 23,7. She was qualified for total laparoscopic radical hysterectomy (Piver type III) and bilateral pelvic lymphadenectomy. Three 5-mm trocars and 0-degree optic laparoscopic camera were used. We also used other instruments such as two atraumatic grasping forceps, a monopolar hook, ThermostaplerR forceps (EMED) with bipolar vessel sealing system and bipolar scissors BiSectR (ERBE) for cutting, coagulation and preparation. Results: The operating time was 220 minutes. Blood loss was 100 ml. The Hb drop was 1,5 g/dl. No intraoperative or postoperative complications occurred. The postoperative hospital stay was 3 days. Final histopathologic test revealed carcinoma planoepitheliale invasivum colli uteri with negative margins of vaginal cuffs. 1 out of the 15 lymph nodes identified in the removed tissue was positive for malignancy. Conclusion: Total laparoscopic radical hysterectomy with bilateral pelvic lymphadenectomy is a safe, effective and minimally invasive technique of diagnosis and treatment in an early stage of cervical cancer. This technique requires further evidence and evaluation before its widespread use.