Surgery for Vaginal Cancer
NYU Langone doctors may perform surgery to manage vaginal cancer. They create a surgical treatment plan based on the location of the tumor and how deeply it has grown into the vaginal wall and surrounding tissue.
Radiation therapy may be given after surgery to destroy any remaining cancer cells, or it may be given before surgery to shrink large tumors.
For early vaginal cancers that have not grown into the vaginal wall, doctors may perform a wide excision. In this procedure the tumor is removed, along with a border of healthy tissue, to ensure that all of the cancer has been removed.
For tumors that have grown less than one half of a centimeter into the vaginal wall, doctors may perform a simple vaginectomy, in which they remove a portion of or the entire vagina.
For tumors than have grown more than one half of a centimeter deep into the vaginal wall, doctors can perform a radical vaginectomy, in which they remove the entire vagina and surrounding tissue.
Lymph Node Dissection
Vaginal cancer can spread to the lymph nodes in the pelvis and groin. For this reason, doctors may surgically remove area nodes, which are examined under a microscope by a pathologist to see if they contain cancer. This can help doctors decide whether another treatment, such as radiation therapy or chemotherapy, is necessary.
If most or all of the vagina has been removed, doctors can perform reconstructive surgery. To do this, muscle and skin are removed from the abdomen or the inner thigh and used to repair or reconstruct the vagina, allowing a woman to have vaginal sex.
Doctors may use a variety of surgical approaches to remove vaginal tumors. Laparoscopic surgery, robotic-assisted surgery, or open surgery may be used for tumors in the upper portion of the vaginal canal. These methods are sometimes combined with a vaginal approach, which may be used to remove tumors in the lower portion of the vagina.
For laparoscopic surgery, doctors make several small incisions in the lower abdomen and pelvic area. 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 remove vaginal tumors.
Doctors at NYU Langone’s Robotic Surgery Center may use a robotic laparoscopic system to remove vaginal tumors. 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. These images guide the surgeon during the procedure. The surgical tools and camera are inserted through small incisions in the abdomen and pelvis, and the surgeon controls them from a console.
For open surgery, surgeons may make an incision or incisions in the lower abdomen or pelvic region to remove vaginal tumors.
Surgery may include inserting small surgical tools directly through the vaginal canal to remove tumors. This is called a vaginal approach.
Recovery from Surgery
The amount of time it takes to recover from surgery for vaginal cancer varies. Procedures may require staying in the hospital for one day or several days, depending on the extent of the surgery.
For example, a woman who has a wide excision procedure may be able to go home the same day. A radical vaginectomy with reconstruction requires more time to recuperate than a simple vaginectomy without reconstruction.
During your stay in the hospital, doctors monitor your overall health and manage any discomfort you may be experiencing. You may have some minor vaginal bleeding for a few days.
You doctor may recommend rehabilitation to help with mobility after surgery. Rehabilitation can also help prevent or manage fluid build up due to the removal of lymph nodes, which can cause a condition called lymphedema.
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