Laparoscopically assisted radical vaginal hysterectomy and radical trachelectomy

• Laparoscopically assisted radical vaginal hysterectomy and radical trachelectomy are newer alternatives to radical hysterectomy. Performed only in certain specialist centres, they are only suitable for small cancers. They are carried out under general anaesthetic.

• For these keyhole surgery procedures, a small cut is made in the belly button and the abdomen is filled with gas. A narrow telescope, called a laparoscope, is then inserted so that the surgeon can see into the abdomen. Various keyhole surgery instruments are passed though other small cuts in the abdomen wall. The surgeon removes the lymph glands in the pelvis through the small cuts.

• In a laparoscopically assisted radical vaginal hysterectomy, the uterus, Fallopian tubes and, sometimes but not always, ovaries are initially freed from their attachments using the laparoscope. The uterus and its surrounding tissue, the cervix and the top part of the vagina are finally removed through the vagina.

• In radical trachelectomy, the cervix and upper part of the vagina are removed, but the uterus is left in place. The lymph glands in the pelvis are also removed, usually by keyhole surgery. This is only suitable for tumours caught in the early stage. As the uterus is left in place, you can, potentially, still become pregnant. A stitch is made at the bottom of the uterus, and this takes the place of the cervix in supporting a pregnancy. A baby would be delivered by Caesarean section.