Trachelectomy (Cervix Removal)

A Trachelectomy (Cervix Removal) is the surgical removal of cervix which is the neck of the uterus. This surgery can be done before a hysterectomy for issues related specifically to the cervix. Younger women may chose trachelectomy over hysterectomy as a means of treating a specific condition while preserving fertility for a future pregnancy.

Before the Procedure

Your physician will also conduct a full physical exam—including blood and imaging tests—on you and your partner to determine your candidacy. One particular test is called a hysterosalpinogram (HSG), which uses dye and X-rays, or saline and air with ultrasound, to examine the length and performance of your remaining fallopian tubes.

Always tell your health care provider or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.

During the days before the surgery:

• You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), and any other drugs that make it hard for your blood to clot.
• Ask your health care provider which drugs you should still take on the day of your surgery.

On the day of your surgery:

• You very often will be asked not to drink or eat anything for 6 – 12 hours before the surgery.
• Take the drugs your health care provider told you to take with a small sip of water. Your health care provider or nurse will tell you when to arrive at the hospital.

 

Trachelectomy (Cervix Removal) procedure

During a Trachelectomy (Cervix Removal) the surgeon removes the cervix, the upper part of the vagina and some of the tissue around the cervix. The rest of the uterus is left in place. The surgeon may use different approaches to do a Trachelectomy:

• Vaginal Radical Trachelectomy (VRT) removes the cervix and the nearby tissue through the vagina. VRT is the most commonly used approach.
• Abdominal Radical Trachelectomy removes the cervix and nearby tissue through the abdomen.
• Laparoscopic Radical Trachelectomy uses a thin, tube-like instrument with a light and lens (called a laparoscope). The surgeon makes small incisions, or surgical cuts, in the abdomen. The laparoscope and other instruments are passed through the small incisions into the abdomen to remove the cervix and nearby tissues.

At the end of the surgery, the surgeon uses a special stitch (called cerclage) to partially close the opening of the uterus where the cervix used to be. This opening allows the flow of menstrual blood during the woman’s period. A temporary catheter may be placed in the opening to help keep it from closing.

The cervical tissue that is removed during surgery is examined under a microscope to see if there are any cancer cells. If there are cancer cells at the edge of the removed tissues (called positive surgical margins), the surgeon may try to remove more tissue. In some cases, the surgeon may need to do a hysterectomy to make sure that all of the cancer is removed..

After a Trachelectomy (Cervix Removal)

If a catheter was placed in the artificial opening between the vagina and uterus, it will be removed about 3 weeks after the surgery.

Follow-up after a Trachelectomy will usually include sampling tissue at the site of surgery (similar to a Pap test procedure) and a Colposcopy, Every 3–4 months for the first 2–3 years after surgery.

Risks

All surgeries carry risks, Trachelectomy (Cervix Removal) while rare, complications may include:

• Bleeding
• Infection
• Deep vein thrombosis, or swelling of the legs
• Vaginal discharge
• Allergic reaction to anesthesia and medication
• Bladder and urination problems
• Painful sexual intercourse