Brigham and Women's Hospital (BWH), one of only a few hospitals in the Northeast to perform robotic radical trachelectomy (removal of the cervix) to treat cervical cancer, is a world leader in using state-of-the-art robotics to improve surgical outcomes. As this advanced technology has significant potential to expand the scope of minimally invasive surgery and shorten patient recovery time, more and more female patients are exploring the option of robotic surgery as a means to treat cervical cancer while maintaining their fertility.
What is a radical trachelectomy?
A radical trachelectomy is the surgical removal of the cervix and a small amount of surrounding supportive tissue, whereas a total radical hysterectomy involves the removal of the entire cervix and uterus. Both procedures are used to treat cervical cancer, but a trachelectomy – by leaving the uterus intact – can give a woman an opportunity to maintain her fertility.
What is a robotic radical trachelectomy?
Robotic radical trachelectomy is a minimally invasive procedure that uses a combination of high-definition 3D magnification, robotic technology and miniature instruments – the FDA-approved da Vinci® Surgical System – to enhance a gynecologic oncologist’s laparoscopic skills when removing a patient’s cervix.
Unlike open radical trachelectomy, which requires one large incision and retraction to accommodate human hands, only five tiny incisions in the abdomen (see image below) are required for the slender robotic arms and tiny surgical tools used in a robot-assisted trachelectomy. There are four available arms - one equipped with a high definition 3-D magnification camera and three that act as the surgeon’s arms - each holding a different instrument, depending on the particular task. The camera gives the surgeon enhanced detail, true depth of field and a panoramic view, and the robotic hands provide dexterity far greater than the human hand. This enhanced visualization, precision, and range of movement provide significant advantages when working around important and delicate structures such as the bladder, nerves, and blood vessels, thereby avoiding potential injury.
These capabilities are further enhanced by the surgical console’s unique ergonomics that help ease surgeon fatigue and mechanics that enable steady movements – remotely guiding the robotic arms while another surgeon, who helps manipulate the uterus, attends to the patient a short distance away. This smooth and effortless motion and the wristed capabilities of the robotic arms are the most significant advantages that robotic surgery has over traditional minimally invasive surgical procedures.
What are the benefits of a robotic radical trachelectomy?
Robotic surgery’s miniaturization, increased range of motion, enhanced vision and mechanical precision offer significant benefits for our trachelectomy patients, including:
- Less blood loss
- Less post-surgical pain/less medication
- Shorter hospital stay
- Quicker recovery and return to normal activities
- Less scarring
- Less likelihood of complications
Who performs robot-assisted trachelectomies at BWH?
Surgical oncologists Neil S. Horowitz, MD, and Michael G. Muto, MD, use the da Vinci® Surgical System to perform robotic trachelectomy at the Dana-Farber Brigham Cancer Center, Gynecologic Oncology Center. If you would like to schedule a consultation with Dr. Horowitz or Dr. Muto, please call the Patient Referral Service – staffed 8am-5:30pm, Monday through Friday – at 1-800-294-9999, or fill out an online request an appointment form.
