Our Summary

This study details a surgical procedure performed on a 52-year-old woman diagnosed with early-stage cervical cancer. The surgery, known as a radical hysterectomy, was carried out using a laparoendoscopic single-site (or LESS) approach. This method uses a single small incision to perform the surgery, making it less invasive than traditional methods. The patient was informed about the risks involved in various surgical methods and she chose the LESS approach. The surgery was successful, with minimal blood loss and no complications. The patient fully recovered bladder function 21 days after the procedure and showed no signs of cancer recurrence after a year. This study demonstrates that, despite the challenges of using the LESS approach for complex surgeries like radical hysterectomy, it can be an effective, safe, and feasible option. The authors also highlight the importance of various flexible suspension techniques, which helped provide a clear view and sufficient exposure during the surgery.

FAQs

  1. What is a laparoendoscopic single-site (LESS) approach in a radical hysterectomy?
  2. What are the benefits of the LESS approach in a radical hysterectomy compared to traditional methods?
  3. What was the recovery process and outcome for the patient who underwent the LESS approach for her radical hysterectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about radical hysterectomy is to discuss the potential impact on fertility and menopause. Radical hysterectomy involves the removal of the uterus, cervix, and surrounding tissues, which can affect a woman’s ability to conceive and may also lead to early menopause. It is important for patients to understand these potential consequences and to discuss any concerns or questions they may have with their healthcare provider. Additionally, patients should be informed about potential side effects, such as changes in sexual function or bladder control, and how to manage them post-surgery. Regular follow-up appointments and communication with your healthcare team are essential for monitoring recovery and addressing any issues that may arise.

Suitable For

Patients who are typically recommended for a radical hysterectomy include those with early-stage cervical cancer, as in the case study mentioned above. Other patients who may be recommended for this procedure include those with:

  • Severe cervical dysplasia or pre-cancerous lesions that have not responded to other treatments
  • Large or recurrent cervical polyps
  • Severe endometriosis affecting the cervix
  • Recurrent or persistent abnormal Pap smear results
  • Cervical intraepithelial neoplasia (CIN) grade 3
  • Certain types of uterine or cervical tumors
  • Patients with a family history of cervical cancer or a genetic predisposition to the disease

It is important for patients to discuss their individual circumstances and treatment options with their healthcare provider to determine if a radical hysterectomy is the best course of action for them.

Timeline

  • Before the radical hysterectomy:
  1. Patient is diagnosed with early-stage cervical cancer.
  2. Patient consults with healthcare providers to discuss treatment options.
  3. Patient learns about the risks and benefits of different surgical approaches, including the laparoendoscopic single-site (LESS) method.
  4. Patient chooses the LESS approach for the surgery.
  5. Pre-operative preparations are made, including physical exams, imaging tests, and discussions about anesthesia and recovery.
  • After the radical hysterectomy:
  1. Surgery is performed using the LESS approach, with minimal blood loss and no complications.
  2. Patient is closely monitored in the immediate post-operative period for any signs of complications.
  3. Patient begins recovery process, including pain management, wound care, and physical therapy.
  4. Patient gradually regains bladder function, with full recovery achieved 21 days after the procedure.
  5. Patient undergoes regular follow-up appointments to monitor for cancer recurrence.
  6. One year post-surgery, patient shows no signs of cancer recurrence, indicating a successful outcome.
  7. Patient may undergo additional treatments or therapies as needed for long-term management of cervical cancer.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a radical hysterectomy using a laparoendoscopic single-site approach?
  2. How does the recovery process differ between traditional methods and the LESS approach for a radical hysterectomy?
  3. What is the success rate of the LESS approach for radical hysterectomy compared to traditional methods?
  4. How long is the typical recovery time after a radical hysterectomy using the LESS approach?
  5. Are there any long-term effects or considerations to be aware of after undergoing a radical hysterectomy using the LESS approach?
  6. What are the alternative surgical options available for a radical hysterectomy, and how do they compare to the LESS approach in terms of effectiveness and safety?
  7. How often do complications occur with the LESS approach for radical hysterectomy, and how are they typically managed?
  8. What factors should I consider when deciding between different surgical methods for a radical hysterectomy?
  9. Are there any specific lifestyle changes or precautions I should take after undergoing a radical hysterectomy using the LESS approach?
  10. How frequently will I need follow-up appointments or screenings after the surgery to monitor for any signs of cancer recurrence?

Reference

Authors: Chen S, Qi X, Chen L, Li F, Wang N, Wang Y, Zheng Y. Journal: J Minim Invasive Gynecol. 2020 May-Jun;27(4):809-810. doi: 10.1016/j.jmig.2019.08.030. Epub 2019 Sep 10. PMID: 31518713