For some women with a small cancer of the cervix, it may be possible to have a trachelectomy. In this type of surgery the cervix and the upper part of the vagina are removed, but the rest of the uterus (womb) is left in place. The operation may be done using keyhole (laparoscopic) or robotically assisted surgery. It may also involve the removal of a selection of the lymph nodes in the pelvis (lymphadenectomy). Your gynae-oncologist will discuss this with you.
Since the uterus is not removed during a trachelectomy, it allows for the possibility that you could go on to have children. Normally a stitch is made in what remains of the cervix to support it during any future pregnancies. Occasionally this stitch will be put in during pregnancy itself. Despite this, during the second trimester of pregnancy there is a significantly higher chance of miscarriage or premature delivery after this procedure. Because the stitch is put in place, the baby will be delivered by Caesarean section. This will usually happen a couple of weeks earlier than full term pregnancies .
Trachelectomy is only suitable for women with early stage cancer of the cervix.
This type of surgery is not common and is only done in specialist gynaecological cancer centres and some centres will not offer this surgery to women who have already completed their families. You may need to ask your gynaecologist to refer you to a specialist hospital or ask for a second opinion if you would like to discuss the possibility of having a trachelectomy. It’s important that your doctor explains the benefits and risk of this procedure to you beforehand.
Watch Emma’s story to hear more about her experience of going though trachelectomy.
Shepherd J H et al, 2006. Radical vaginal trachelectomy as a fertility-sparing procedure in women with early-stage cervical cancer-cumulative pregnancy rate in a series of 123 women. BJOG 113(6), 719–724.
"I chose to have a trachelectomy because I want to have children in the future"
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