Objective To show three different cases of laparoscopic approach in patients with previous hysterectomy.
Settings Three patients with cervical or vaginal cancer with previous hysterectomy, solved by laparoscopy.
Methods The first patient has personal history of ovarian cancer, treated with surgery with subtotal hysterectomy and intraperitoneal chemotherapy. In oncological follow up she has cervical tumour whose biopsy indicates a relapse of her disease.
The second patient has a personal history of total hysterectomy in 2010 for high-grade squamous intraepithelial (HSIL) cervical lesions. In annual gynaecological control a posterolateral lesion was identified in the vaginal cuff. It´s biopsy informed a squamous carcinoma.
The third patient has a history of subtotal hysterectomy for benign disease.
Annual pap smear shows HSIL. Cervical biopsy informed a squamous carcinoma. On physical examination the patient had a 2 cm tumor without evidence of parametrial involvement. IB1 FIGO stage.
In all three cases we begin with an exploratory laparoscopy in order to discard intraperitoneal disease. we used a vaginal acrylic tube as a colpotomizer.
In each case, the radicality was adjusted to the disease the patients.
Conclusion After hysterectomy, cervical or vaginal malignancies could be diagnosed. In order to solve them, we choose the laparoscopic approach. Is important in this kind of surgeries, to have a colpotomizer that facilitates the procedure. In our cases we used a vaginal acrylic tube, resistant to the monopolar energy. The radicality of each surgery depends on the malignancy and the patient.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.