Robotic radical trachelectomy in early stage cervical cancer.

Abstract

Radical trachelectomy represents an alternative for early stage cervical cancer in patients who want to preserve fertility. This procedure can be performed by vaginal, open or minimal invasive approach. The robotic approach may offer some advantages, especially for the surgeon´s ergonomics. Since the evidence is still scarce, larger studies are needed. Our objective is to present a retrospective review of our experience with robotic radical trachelectomy. Descriptive study carried out in Clinico San Carlos University Hospital, Madrid, Spain. We included all our patients with early stage cervical cancer that wished to preserve fertility, from 2023 to 2022. The surgery included bilateral pelvic lymphadenectomy followed by radical trachelectomy and cervical cerclage after confirmation of absence of nodal metastasis. Demographic data of the study population, perioperative and oncological outcomes were analyzed. Seven patients who underwent radical robotic trachelectomy were studied. Median patient age was 30 (range 23-35) years. Median body mass index was 24 (range 19-28). Tumor histology was squamous cell carcinoma in 57% (4) and adenocarcinoma in 43% (3) of the patients. Median surgical time was 285 (range 247-315) min. The median of pelvic nodes obtained was 15 (range 12-40). Two postoperative complications were observed. One patient tried to conceived and had preterm labor. One patient died of the disease. In selected cases, robotic radical trachelectomy is a safe option for patients that wish to preserve their fertility with similar rates of oncological safety and complications than open procedures and a shorter recovery time.