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Surgical Procedures for Cervical Cancer

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Surgery is the most common treatment for cervical cancer. The goal is to remove any abnormal tissue or tumor(s). It is also to protect the cervix and its function, as much as possible.

CIN can develop into cervical cancer. The risk is reduced by treating it early. This means removing the abnormal tissue.

The type of surgery depends on:

  • The grade of the abnormal cells
  • The stage of cancer and how much treatment is needed
  • If a person wants to have children someday
  • Age and general health

Surgery for CIN and Early Stage Cervical Cancer

Cryosurgery

Cryosurgery freezes off the abnormal cells. A probe is put into the vagina and a substance is applied to the cervix. This can be done in a doctor's office.

Laser Surgery

A laser beam heats and kills the abnormal cells. This can be done in a doctor's office.

Conization

Conization is the removal of a cone-shaped piece of tissue from the cervix. It can be done with a scalpel, cold knife, laser beam, or loop electrosurgery (LEEP). After tissue is removed, the area around the sample is checked for abnormal cells. This helps determine if more treatment is needed.

It is called a cone biopsy when used to diagnose abnormal cells and cancer.

Surgery for Advanced Cervical Cancer

Hysterectomy

A hysterectomy is surgery to remove the uterus (womb) and cervix. Sometimes the fallopian tubes and ovaries are removed as well. The doctor may also choose to remove pelvic lymph nodes. The amount of surgery depends on how much cancer there is.

Hysterectomies can be:

  • Open —The uterus and cervix are removed through an incision in the belly.
  • Laparoscopic —Tubes are inserted into small incisions. Lights, a camera, and tools can be used through the tube. Images from the laparoscope are seen on a monitor.
  • Robotic assisted —Robotic arms are inserted through small incisions. They have a greater range of movement than a doctor's hand.

A hysterectomy can also be done through the vagina. The vagina is kept open with special tools. The uterus and cervix are then removed through the vagina. If a laparoscope is used, a thin scope is inserted near the navel.

Trachelectomy

Trachelectomy (or cervicectomy) is removal of the cervix. It can be done through the belly or vagina. Surgery methods may be the same as above.

Women who have this surgery may be able to have children. However, they have a much higher risk of a premature birth or miscarriage. When delivering a baby, they will need a c-section.

Pelvic Exenteration

This procedure is for cancer that has spread to nearby organs. Depending on where the cancer has spread, other organs are removed. This may include the vagina, bladder, rectum, or lower part of the colon. If the bladder, rectum, and/or part of the colon are removed, more surgery will be needed. A urostomy and/or colostomy will be done so the body can remove wastes. A vagina can be reconstructed from other tissues.

 

Pelvic Lymph Node Dissection

Cervical cancer can spread to lymph nodes in the pelvis. Once there, it can travel to other parts of the body. During surgery, the doctor will remove the lymph nodes that may have cancer. The nodes will be checked in the lab.

REFERENCES:

Cervical cancer. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/cervical-cancer. Accessed April 21, 2021.

Cervical cancer. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/gynecology-and-obstetrics/gynecologic-tumors/cervical-cancer. Accessed April 21, 2021.

Management of abnormal cervical cytology. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/management-of-abnormal-cervical-cytology. Accessed April 21, 2021.

Management of cervical intraepithelial neoplasia (CIN) and adenocarcinoma in situ (AIS). EBSCO DynaMed website. Available at: https://www.dynamed.com/management/management-of-cervical-intraepithelial-neoplasia-cin-and-adenocarcinoma-in-situ-ais. Accessed April 21, 2021.

Ramirez PT, Frumovitz M, et al. Minimally invasive versus abdominal radical hysterectomy for cervical Cancer. N Engl J Med. 2018;379(20):1895-1904.

Surgery for cervical cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/cervical-cancer/treating/surgery.html. Accessed April 21, 2021.

Treatment options by stage. National Cancer Institute website. Available at: https://www.cancer.gov/types/cervical/patient/cervical-treatment-pdq#section/_201. Accessed April 21, 2021.

Last reviewed March 2021 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP  Last Updated: 4/21/2021