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838 Use of mechanical cutting and suturing device for colpectomy in cervical cancer surgery
  1. Javier Lopez Zajara,
  2. Jose Luis Colombo Garcia,
  3. Higinio Vidal Roncero,
  4. Gloria Reina Vinardell and
  5. Rafael Torrejon Cardoso
  1. Hospital Puerta del Mar, Cadiz, Spain


Introduction/Background Cervical cancer is the fourth most common cancer in women worldwide, but it is considered the third cause of death from cancer between 15 and 45 years of age.

Its staging is pre-surgical and will determine the most appropriate treatment, such that cervical tumors with FIGO stages IA1, IA2, IB1 and IIA1 will have surgery as the ideal initial treatment.

Until recently, what was considered minimally invasive surgery (laparoscopy and robotic surgery) competed ‘on equal terms’ with laparotomy, but the publication of the LACC study in 2018 represented a true revolution in the decision-making of the surgical route for the treatment of cervical cancer. The demonstration of an unacceptable increase in the incidence of local recurrences after laparoscopic surgeries led to proposing a series of measures to try to solve the problem

Methodology Descriptive case study

Results We present the case of a 42-year-old patient diagnosed with FIGO IB1 cervical adenocarcinoma with a largest diameter of 23 mm.


Conclusion The novelty used on this occasion is the use of Endogia-type mechanical suture (60 mm/6-row/4.6 mm for Da Vinci system) to perform watertight colpectomy and avoid possible tumor dissemination or performing a laparotomy to extract the colpectomy. part. After the colpectomy, the vaginal rim is trimmed with staples and sent to the Pathology Service, serving as a safety sleeve.

The postoperative evolution was adequate After evaluating the case in the tumor committee, complementary brachytherapy was indicated. The patient currently continues to have her periodic check-ups without incidents

Disclosures Since we have the Da Vinci (Xi) robotic device, we perform all neck cancer surgeries using this means. We believe that it allows us to improve the visualization of structures and facilitate nerve preservation techniques.

Currently, different techniques are being used to isolate the cervical tumor, and allow minimally invasive surgery (conization to reduce tumor mass, initial dissection and closure of the upper third of the vagina, use of unapproved or little-known instruments...) we think that the Isolation of the vagina using Endogia-type mechanical suture can be a safe method to carefully manipulate the piece in the pelvis and avoid the spread of tumor cells as much as possible. Its main problem may be the relative technical difficulty that it entails since it requires a low vaginal dissection with complete identification of the ureters and great caution when applying the instrument so as not to injure neighboring structures

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