Dacatra

Fertility-Sparing Robotic-Assisted Radical Trachelectomy and Bilateral Pelvic Lymphadenectomy in
Early Stage Cervical Cancer

Objective: To illustrate a case of robotic-assisted radical trachelectomy in a patient with invasive
adenocarcinoma of the cervix.
Methods: This 30-year-old, para-1 woman was diagnosed with adenocarcinoma in situ of the cervix in an
endocervical polyp when she presented without complaint to her postpartum visit. She was a nonsmoker
with no history of abnormal Pap smears. She subsequently underwent a cold knife conization that
revealed invasive adenocarcinoma of the cervix with lymphovascular invasion. Endocervical curettage
and endometrial biopsy were benign. Pelvic examination revealed a stage IB1 adenocarcinoma of the
cervix. All options for management were reviewed, and the patient expressed a strong desire for
fertility sparing surgery.
Results: She underwent a robotic-assisted radical trachelectomy and bilateral pelvic lymphadenectomy
to treat her early stage cervical cancer. A polyethylene cerclage was placed at the termination of
the procedure. Her estimated blood loss was 200cc, and she suffered no postoperative complications.
She resumed a normal menses 4 weeks postoperatively.
Conclusions: This represents the first case of a patient with early cervical adenocarcinoma managed
with robotic-assisted radical trachelectomy and pelvic lymphadenectomy. This technique combines the
advantage of open and laparoscopic procedures with a familiar anatomic approach, increased
magnification, and the superior dexterity of robotic surgery. We hope, with rapid acceptance of
robotic surgery in gynecologic oncology, robotic radical trachelectomy will make fertility sparing
options a more accessible option for select women with early stage cervical cancer who desire
fertility preservation.