Cervical Cancer Surgery
For cancer that has not spread beyond the cervix, Perlmutter Cancer Center surgeons may perform a hysterectomy, which is the surgical removal of the uterus and cervix. Hysterectomy may also be recommended for some women with precancerous conditions of the cervix who are considered to be at higher risk of developing cervical cancer.
The goal of surgery for women with cervical cancer is the removal of all cancer. Whenever possible, our gynecologic oncologists use minimally invasive techniques, such as laparoscopy or robotic approaches, to perform these surgeries.
For the smallest cancerous growths confined to the cervix, our doctors may remove only the uterus, including the cervix.
For larger tumors confined to the cervix, your doctor may remove the cervix, the tissue surrounding the cervix, the uterus, the upper portion of the vagina, and the bands of connective tissue in the pelvis called the parametrium (radical hysterectomy).
Surgery also includes the removal of nearby lymph nodes. Lymph nodes are small glands located throughout the body that filter foreign matter, such as bacteria and viruses. Cervical cancer often spreads to the lymph nodes of the pelvis before spreading elsewhere.
Sentinel Lymph Node Biopsy
In certain situations, doctors may sample sentinel lymph nodes instead of performing a more extensive procedure to remove area nodes. During a sentinel lymph node biopsy, which takes place in a hospital operating room, a surgeon injects a tracer into the cervix. The tracer travels through tissue to nearby lymph nodes. The first node to absorb the tracer is called the sentinel node. It is usually the lymph node closest to the cancer.
Doctors surgically remove this sentinel lymph node, which a pathologist examines under a microscope for signs of cancer. If the node is free of cancer cells, no additional lymph nodes are removed because cervical cancer has most likely not spread.
If the sentinel node contains cancer cells, additional nodes are surgically removed and evaluated under a microscope to determine whether they contain cancer.
Whenever possible, surgeons at NYU Langone perform hysterectomy using one of two minimally invasive techniques. Both forms of minimally invasive surgery provide doctors with an excellent view of any tissue that needs to be removed as well as surrounding organs, blood vessels, and nerves, enhancing their ability to perform delicate procedures.
In laparoscopic surgery, doctors make several small incisions in the lower abdomen and pelvis. They inflate the abdomen with air to create a working space, and place a laparoscope, which is a lighted tube with a tiny camera on it, through one of the incisions. Through the remaining incisions, they insert small surgical tools that they use to perform the surgery.
Laparoscopic surgery can reduce recovery time and result in less scarring than open surgery, which requires a larger incision.
Doctors at NYU Langone’s Robotic Surgery Center may use a robotic laparoscopic system to perform a hysterectomy. This system consists of tiny surgical instruments mounted on three separate robotic arms. A fourth arm contains a camera that creates magnified, high-definition, three-dimensional images on a computer monitor that guides the surgeon during the procedure. The surgical tools and camera are inserted through small, quarter-inch incisions in the abdomen and pelvis, and the surgeon controls them from a console in the operating room.
Similar to laparoscopic surgery, robotic surgery can reduce recovery time and result in less scarring than open surgery.
During open surgery, a doctor makes an incision in the lower abdomen and pelvis to perform the hysterectomy. Open surgery may be necessary in women who have scarring from previous abdominal or pelvic procedures that makes minimally invasive techniques difficult to perform. Open surgery may require a hospital stay.
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