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Most women with cervical cancer will undergo some type of surgery. Surgery can be used to help diagnose cervical cancer, determine how far cancer has spread, and help treat cancer (especially for early-stage cancers).
Surgery to Treat Pre-Cancers of the Cervix
Two types of procedures that can be used for treating pre-cancers of the cervix are:
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Ablation destroys cervical tissue with a laser or cold temperature rather than removing it.
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Excisional surgery (conization) cuts out & mitigates the pre-cancer.
For effective surgical management of cervical cancer, consult a top surgical oncology hospital in Sarjapur Road, Bangalore.
Cryosurgery for Cervical Cancer
Cryosurgery is an ablation procedure where a very cold metal probe is placed directly over the cervix. This removes the abnormally growing cells by freezing them. It is used for treating Cervical Intraepithelial Neoplasia (CIN). This can be done in a surgeon's or gynecologist's office or clinic. After cryosurgery, the patient may have a watery, brown discharge for a few weeks.
Laser Ablation for Cervical Cancer
Laser ablation transmits a focused laser beam via the vagina to vaporize (burn-off) abnormal cells. This might be done under local anesthesia (numbing medicine) or in the operating room with general anesthesia since it can cause more discomfort than cryotherapy. It is also used for treating Cervical Intraepithelial Neoplasia (CIN).
Conization for Cervical Cancer
Another way to treat and manage Cervical Intraepithelial Neoplasia (CIN) is through an excisional surgery called conization. Here, the operating surgeon removes a conical-shaped piece of tissue from the cervix. The tissue removed in the cone shape includes the transformation zone, where cervical pre-cancers & cancers are most likely to start their growth. A cone biopsy is not only used to diagnose pre-cancers and cancers but it can also be used as a treatment since it can sometimes completely remove pre-cancers and some very early cancers.
Surgery for Invasive Cervical Cancer
Procedures to treat invasive cervical cancer are Hysterectomy (simple or radical) and Trachelectomy:
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Simple Hysterectomy
A simple hysterectomy removes the uterus (both the body & the cervix), but not the structures next to the uterus (parametria and uterosacral ligaments). The vaginal and pelvic lymph nodes are not removed in this case. The ovaries are usually left in their place unless there is any need for removing them. A simple hysterectomy can be used to treat certain types of severe CIN or certain types of very early cervical cancer.
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Radical Hysterectomy
For this procedure, the surgeon removes the uterus along with the tissues adjacent to the uterus (the parametria & the uterosacral ligaments), the cervix, & the upper part (around 1 inch [2–3 cm]) of the vagina next to the cervix. The ovaries are not removed unless some medical reason comes into play. More tissue is removed in a radical hysterectomy than in other procedures, so the hospital stay can be longer. Some lymph nodes will also be removed & examined for cancer at this time.
This surgery is typically done through a large abdominal incision (also known as open surgery). In most cases, some pelvic lymph nodes are also removed. A radical hysterectomy can also be performed using laparoscopy or robot assistance. These techniques are also called minimally invasive surgery.
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Trachelectomy
A radical trachelectomy allows women to be treated without affecting their ability to have children. The procedure is done either through the vagina or the abdomen & is sometimes performed using laparoscopy.
This surgery removes the cervix & the upper portion of the vagina, but not the body of the uterus. The surgeon then inserts a permanent "purse-string" stitch within the uterine cavity to keep the opening of the uterus closed similar to the way the cervix normally does. The nearby lymph nodes are also removed through laparoscopy, which may require another incision or cut. The operation is done either via the abdomen or the vagina.
After a trachelectomy, some women are able to carry a pregnancy to term and deliver a healthy baby by caesarean section, although women who have had this surgery might have a higher risk of miscarriage.
Surgery to Remove Nearby Lymph Nodes
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Pelvic lymph node dissection
Cancer that originates in the cervix can spread to the lymph nodes (tiny-sized collections of immune system cells) in the pelvis. To check for lymph node spread, the surgeon may remove some of these lymph nodes. This surgery is referred to as a pelvic lymph node dissection or a lymph node sampling. It is done similarly to a hysterectomy or trachelectomy.
Consult a top surgical oncologist in Sarjapur Road, Bangalore for the best treatment and care.
Manipal Hospitals, Sarjapur Road, Bangalore
