The role of Laparoscopic Surgery in the Treatment of Gynaecological Cancers

The global cancer incidence in women is reaching sky high where breast cancer contributes to 25.4% of the total number of new cancer cases diagnosed (in 2018). The top three cancers in women are the breast, cervical and lung cancers which contribute to over 30% of all cancers globally. In India, cervical cancer takes the life of one woman every 8 minutes.

These numbers are there not for you to panic but to raise awareness and keep you alert to cancer symptoms. Many cancer symptoms may look like common conditions or ailments, but it’s always good to bring it up with your doctor. Because when it comes to cancer, the best ways to defeat it is by detecting it as early as possible.

What is Gynaecological Cancer?

1 out of 4 of all cancers in women in developing countries is gynaecological cancer. They are cancers that start in a woman’s reproductive system. Depending on the site of origin, the cancers are of a different kind, and the treatment of it depends on the same (where cancer started).

The five gynaecological cancers are:

  • Cervical cancer: Cancer (abnormal proliferation of cells) that starts in the cervix (the neck of the womb).
  • Womb cancer: The womb or uterus is a pear-shaped muscular bag in which the fetus implants and nurtures during the pregnancy. When the lining of the womb starts dividing uncontrollably, then this is termed as uterine or endometrial cancer.
  • Ovarian cancer: Ovarian cancer develops in the ovaries. It is the proliferation of cells in an uncontrolled manner.
  • Vaginal cancer: It is a rare condition where the cells in the vagina multiply uncontrollably. It is seen as more common in older women.
  • Vulval cancer: It is a rare condition where the cancer cells start to develop in the female external sex organs, the vulva.

What is Laparoscopic Surgery?

Laparoscopic surgery is a minimally invasive surgery. It is a specialized technique of performing surgery which is assisted by a laparoscope. A laparoscope is a thin, long tube which has a high-intensity light and a high-resolution camera that sends images to a video monitor. In the procedure, a laparoscope is inserted through a small incision in the abdominal wall, and the surgery is performed. It is a low-risk, minimally invasive procedure that requires only tiny incisions.

What is the role of Laparoscopic Surgery in the Treatment of Gynaecological Cancers?

Laparoscopic surgery is a low-risk, minimally invasive procedure that requires only small incisions. In laparoscopic surgery the hospital stay is shorter (2-3 days), the pain and scars are minimal, and the patient can resume daily routine activity within a week time.

The laparoscopic surgeries for the gynaecological cancers are performed for all the endometrial cancers (uterus), small-sized (<2cm) cervical cancers and small-sized (<8cm) early-stage ovarian cancers. It is also performed for benign and borderline tumours. Let’s get into more details.

Laparoscopic Surgery in the Treatment of Ovarian Cancer

The patients with ovarian cancer can be treated (minimally invasive surgery) in different ways depending on the stage and the surgical goals of the procedure.

In early-stage, the small-sized tumours less than eight cms and having tumour confined only to the ovaries may be treated by laparoscopic staging surgery (removing uterus, ovaries, peritoneal fluid, lymph nodes, and omentum) and the tumour is removed in an endobag without the spillage.

In advanced-stage, laparoscopy is used to confirm the diagnosis and determine resectability.

Laparoscopic Surgery in the Treatment of Uterine Cancer or Endometrial Cancer

More than 95% of uterine (endometrial) cancers are treated with total laparoscopic hysterectomy with bilateral salpingo-opherectomy (TLHBSO) and retroperitoneal lymph nodes removal (RPLND). The RPLND may be avoided by doing a sentinel nodal study.

A small number of uterine cancer cases which are not fit for the general anaesthesia due to the severe associated medical disease like diabetes, hypertension, and obesity may be treated with vaginal hysterectomy/laparoscopic-assisted vaginal hysterectomy with bilateral salpingo-opherectomy (LAVH/BSO).

Laparoscopic Surgery in the Treatment of Cervical Cancer

The precancerous lesions, micro-invasive, and small-sized (less than two cms) cervical cancers are treated by simple, type I-II and type III laparoscopic radical hysterectomy with pelvic lymph nodes removal respectively. The young patients desiring to retain uterus for their future fertility are treated by radical vaginal trachelectomy or Dargent operation and laparoscopic pelvic lymphadenectomy. In Dargent operation, a laparoscopic pelvic lymph node dissection is made, this is followed by the surgical resection of the cervix and upper vagina (via vaginal approach)

An endocervical and endometrial sampling just above the radical trachelectomy specimen is taken to stage cancer.

Why choose Cytecare cancer hospital?

Early detection of any form of cancer elevates the chances of successful treatment. So, keep an eye for any changes you observe and get it checked at the earliest. You can trust Cytecare if you need more information. At Cytecare we are “Fighting Cancer the Right Way” with highly specialized, modern diagnostic services, treatment and care for cancer patients. Guided by national as well as global protocols our multidisciplinary team of clinicians is highly qualified to help you fight cancer the right way. Give us a try!

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