Obstet Gynecol Sci.  2021 May;64(3):317-321. 10.5468/ogs.19127.

Vaginal delivery after robot-assisted uterine artery-preserving radical trachelectomy for early-stage cervical cancer

• Lee N
• Mun J
• Park SJ
• Lee EJ
• Lee S
• Kim HS

• KMID: 2515984
• DOI: http://doi.org/10.5468/ogs.19127

Abstract

Radical trachelectomy is conducted in women with early stage cervical cancer who strongly desire fertility preservation. To improve fertility outcomes, the preservation of the uterine artery has been suggested, which can be feasible by minimally invasive surgery using laparoscopy or robots. Although cesarean delivery is required for maternal and fetal health, vaginal delivery is a concern due to the fast delivery process of risk of preterm labor. We report a case of a 32-year-old nulliparous woman with stage IB1 cervical cancer who underwent robot-assisted uterine artery-preserving radical trachelectomy for improving fertility. This case is meaningful because she delivered by vaginal delivery after incision of the fibrotic ring at the level of uterovaginal anastomosis because delivery proceeded too quickly prior to the preparation of the cesarean delivery.

Keyword

Cervical cancer; Robot-assisted radical trachelectomy; Preservation of the uterine arteries; Vagianl delinvery

Figure

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  Fig. 1 Procedures for preserving the uterine artery in robot-assisted radical trachelectomy: (A) tunneling of the left ureter with the preservation of the left uterine artery; (B) division of the left vesicouterine ligament; (C) ligation of the left deep uterine vein; (D) division of the left anterior parametrium; (E) anterior colpotomy; (F) division of the paracolpos; (G) division of the cervical branch of the left uterine artery; and (H) amputation of the cervix at the level of the isthmus.

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  Fig. 2 Postoperative view of the vaginouterine reanastomosis site at six months after surgery.

Reference

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