Cervical cancer is 4th most common cancer in women globally. Data shows that in 2024, there were more than 6.7 lakh new cases of cervical cancer was reported worldwide. Approximately 3.5 lakh deaths were occurred last year due to cervical cancer. HPV virus is the main causative factor. Poor personal hygiene; smoking, etc also contribute to development of cervical cancer. Vaccine against HPV is a very effective methodology of cervical cancer prevention.
Early-stage cancer can be treated with minimally invasive methods having minimum morbidity
In layman terms as when disease is limited to cervix majorly with occasional involvement of upper 2/3rd vagina only with no spread to adjacent tissue i.e. Parametrium or any other organ such as anteriorly bladder or posteriorly rectum. Even Lymph Nodes are supposed to be negative on radiological evaluation.
According to FIGO Classification Early stage comprises of Stage 1A; 1B and 2A
Surgery is the first line treatment in early stage cervical cancer
Ovaries are generally preserved during Cervical Cancer surgical procedure
The very early stage cancers such as 1A stage with depth of invasion being < 5mm can be managed with Tracehelectomy i.e. removing of cervix only, with preservation uterus and ovaries
The stages 1B and 2A need complete Radical Hystrectomy i.e. removal of uterocervical complex with adequate margins as well as bilateral pelvic lymph nodes.
The standard method is the Open procedure i.e. doing an Exploratory Laprotomy (opening up the abdomen). It is a surgical incision into the abdominal cavity. It allows access to internal organs
In such cases, using minimally invasive method especially Robotic assistance is being debated on.
In my opinion as a proficient robotic surgeon it should definitely be considered especially in early stage patients when disease is limited to cervix without extention to vagina and parametrium
1. Robot gives definitive advantage in access to depths of pelvis, I am more confident of vaginal margin while using the Robotic assistance.
2. With use of FireFly imaging present in Robot the ureter i.e. the tube bringing urine from kidney to bladder is seen easily and its damage is minimized
3. The Sentinel Lymph node station of draining lymph node is defined more precisely with Robot thus, overall also lymph node dissection is more defined, lymphorrhea is much lesser and the dreaded complication of Deep Vein Thrombosis is decreased. Lymphorrhea is the leakage of lymphatic fluid, often after surgical procedures. It can cause an increased risk of infection.
This is apart from Standard benefits of robotic surgery such as no scars, lesser blood loss, swift recovery. Considering this benefits, robotic surgery should be considered in select patients at early stage of disease
Dr Mandeep Singh Malhotra
Senior oncologist
Art of healing cancer
Early-stage cancer can be treated with minimally invasive methods having minimum morbidity
In layman terms as when disease is limited to cervix majorly with occasional involvement of upper 2/3rd vagina only with no spread to adjacent tissue i.e. Parametrium or any other organ such as anteriorly bladder or posteriorly rectum. Even Lymph Nodes are supposed to be negative on radiological evaluation.
According to FIGO Classification Early stage comprises of Stage 1A; 1B and 2A
Surgery is the first line treatment in early stage cervical cancer
Ovaries are generally preserved during Cervical Cancer surgical procedure
The very early stage cancers such as 1A stage with depth of invasion being < 5mm can be managed with Tracehelectomy i.e. removing of cervix only, with preservation uterus and ovaries
The stages 1B and 2A need complete Radical Hystrectomy i.e. removal of uterocervical complex with adequate margins as well as bilateral pelvic lymph nodes.
The standard method is the Open procedure i.e. doing an Exploratory Laprotomy (opening up the abdomen). It is a surgical incision into the abdominal cavity. It allows access to internal organs
In such cases, using minimally invasive method especially Robotic assistance is being debated on.
In my opinion as a proficient robotic surgeon it should definitely be considered especially in early stage patients when disease is limited to cervix without extention to vagina and parametrium
1. Robot gives definitive advantage in access to depths of pelvis, I am more confident of vaginal margin while using the Robotic assistance.
2. With use of FireFly imaging present in Robot the ureter i.e. the tube bringing urine from kidney to bladder is seen easily and its damage is minimized
3. The Sentinel Lymph node station of draining lymph node is defined more precisely with Robot thus, overall also lymph node dissection is more defined, lymphorrhea is much lesser and the dreaded complication of Deep Vein Thrombosis is decreased. Lymphorrhea is the leakage of lymphatic fluid, often after surgical procedures. It can cause an increased risk of infection.
This is apart from Standard benefits of robotic surgery such as no scars, lesser blood loss, swift recovery. Considering this benefits, robotic surgery should be considered in select patients at early stage of disease
Dr Mandeep Singh Malhotra
Senior oncologist
Art of healing cancer
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