Introduction/Background Cervical stump cancer occurs after 2 years or longer of subtotal hysterectomy that was performed for benign gynecologic diseases (including uterine myoma, endometriosis, pelvic inflammatory diseases, ovarian cyst), obstetric diseases (rupture of the uterus, severe postpartum hemorrhage).
Methodology The procedure is performed under general anesthesia. A Vcare uterine manipulator is placed vaginally. a veress needle is placed in the umbilicus for peritoneal insufflation. A 2 cm incision over the lower rim of the umbilicus was performed. The patient was placed in the Trendelenburg position, and the DaVinci SP robotic surgical system is side-docked parallel to the right side of the patient. Pelvic lymphadenectomy was performed. Dissection boundaries: The lateral bound is the medial bound of the psoas major muscle, the medial bound is the terminal branch of the internal iliac artery, the upper bound is 3 cm above the common iliac artery, the lower bound is deep inguinal lymph nodes, and the bottom bound is obturator nerve. Radical trachelectomy. Type B1 of radical hysterectomy was performed. The procedure lasted for 180 minutes, and blood loss during the operation was 50 milliliters. Abdominal incisions are closed with O vicryl suture.
Results The patient had an uneventful post-operative recovery. The operating time was maintained at 180 minutes, and the console time was 130 minutes. The estimated blood loss was 50 ml. The patient was discharged home 2 days after surgery.
Conclusion Robot-assisted surgery has the advantages of the three-dimensional view, wrist system, and tremor filtration, reducing the scale of movements, improving ergonomics, and allowing more flexible joint activities and a higher degree of freedom, thus more precise operations can be performed. Farghaly’s technique of robot-assisted trachelectomy for early-stage uterine cervical cancer stump is feasible and has the advantage of decreasing morbidity, reducing the risk of dissemination, and short hospital stay.
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