Surgery for Gynaecological Cancers

We specialise in treatment of gynaecological cancers. We can advise the best treatment approach, potentially combining surgery with chemotherapy and radiotherapy.
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Surgery for Cervical Cancer

There are two types of surgery available to treat cervical cancer: trachelectomy or radical hysterectomy. Your choice for surgery will depend on the size and position of the cancer, as well as your desire to become pregnant in the future.
Trachelectomy
A trachelectomy is a surgical procedure designed for early-stage cervical cancer patients who desire to preserve their fertility. This procedure involves the removal of the cervix (the neck of the womb), surrounding parametrial tissue, and a small section of the upper portion of the vagina.

During the trachelectomy, a durable permanent suture is placed around the uterine opening, providing sufficient support for potential future pregnancies while still allowing for regular menstrual cycles and conception. The uterus, ovaries, and fallopian tubes are left intact. Additionally, a sample of pelvic lymph nodes is extracted since cervical cancer can potentially spread to these nodes, and these nodes are then examined for the presence of cancer cells.

This surgery is performed under general anaesthesia, ensuring that you are comfortably asleep throughout the procedure.
Radical Hysterectomy
A radical hysterectomy, also known as a Wertheim's hysterectomy, might be recommended when the cancer is localized to the cervix, and your primary concern is not preserving fertility. This procedure involves the complete removal of the uterus (womb), cervix (the neck of the womb), parametrial tissue, fallopian tubes, the upper portion of the vagina, pelvic lymph nodes, and occasionally, the ovaries.

This surgery is performed under general anaesthesia, ensuring that you are unconscious throughout the procedure. The primary objective of this surgery is the complete eradication of the cancer. If there is any indication that the cancer has spread, additional treatments such as radiotherapy or chemotherapy may be proposed. The decision on further treatment will be discussed with you once all your test results are available.

A hysterectomy will remove your ability to get pregnant. It is important to decide whether this is important for you before proceeding with surgery.

Hysterectomy can be performed through multiple approaches which will result in different scarring. The approaches we offer at Gynae Health Clinic include abdominal hysterectomy, laparoscopic (keyhole) hysterectomy, and robotic hysterectomy.

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Surgery for Ovarian Cancer

The surgical procedure for suspected Primary Peritoneal Cancer (PPC) or an ovarian mass typically involves the removal of various components, including the mass itself, ovaries, uterus (womb), cervix (the neck of the womb), fallopian tubes, lymph nodes, and the omentum (a fatty apron-like tissue in the upper abdomen).

The extent of the surgery required may vary from one individual to another, and this will be a topic of discussion with you and your healthcare team. The operation is performed under general anaesthesia, ensuring that you are in a deep sleep throughout the entire procedure.

The surgeon will create a vertical incision (referred to as a midline incision) and then secure the incision with dissolvable stitches. In the period following the surgery, the region surrounding the scar may experience temporary numbness, but sensation typically returns.

The primary objective of the procedure is to safely extract the mass, tumor, or cyst.

Everything removed during your surgery will be forwarded to the histology laboratories for testing. These tests typically require about three weeks. Subsequently, you will have a follow-up appointment in the clinic, during which you will review these results with your consultant. At this meeting, you will learn the grade and stage of your cancer.

If there is any indication of cancer, you may be presented with additional treatment options, such as chemotherapy.

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Hysterectomy

A hysterectomy is a surgical procedure that involves the removal of the uterus (womb) and its neck (cervix). Typically, both the fallopian tubes and ovaries are also removed in a bilateral salpingo-oophorectomy. Additionally, it may be necessary to extract certain pelvic glands, known as lymph nodes. In some cases, a small tissue sample, referred to as a biopsy, might be obtained from other lymph nodes located in your abdominal region.

This surgery is performed under general anaesthesia, ensuring that you are unconscious throughout the procedure. The primary objective of this surgery is the complete eradication of the cancer. If there is any indication that the cancer has spread, additional treatments such as radiotherapy or chemotherapy may be proposed. The decision on further treatment will be discussed with you once all your test results are available.

A hysterectomy will remove your ability to get pregnant. It is important to decide whether this is important for you before proceeding with surgery.

Hysterectomy can be performed through multiple approaches which will result in different scarring. The approaches we offer at Gynae Health Clinic include abdominal hysterectomy, laparoscopic (keyhole) hysterectomy, and robotic hysterectomy.

Vulval Surgery

Women diagnosed with vulvar cancer may require surgical intervention to remove a portion or all of the affected tissues in this region.

The specific surgical approach will be determined based on factors such as the size and location of the cancer, your overall health, and any accompanying symptoms like discomfort, pain, burning, or itching.

The primary goal of the surgery is to completely eliminate the cancer while making every effort to preserve as much vulval tissue as possible. Surgery for vulvar cancer in its early stages typically boasts a high success rate. Nevertheless, if the cancer has advanced or spread, radiation therapy to the affected area may be recommended as part of the treatment plan.
Skin Removal Procedure for VIN (Vulval Intraepithelial Neoplasia)
This surgical intervention, known as a skinning vulvectomy, is employed to address vulval intraepithelial neoplasia (VIN). VIN represents a pre-malignant skin condition characterized by abnormal surface cells on the vulva. While not cancerous, it carries a slight long-term risk of evolving into cancer. Given that the affected cells are limited to the surface of the vulva, it is feasible to remove only the affected skin, leaving the healthy tissue underneath. Typically, you can expect to return home either the same day or the day after the procedure.
Wide Local Excision
When the cancer is relatively small, a wide local excision is typically recommended. This surgical approach entails the removal of the cancerous area along with a margin of healthy tissue surrounding it. In some cases, this procedure may also involve the removal of lymph nodes from the groin on the same side as the cancer, known as lymph node dissection. The duration of your hospital stay following this operation can range from one to three days, depending on the extent of the surgery.
Partial Vulvectomy
A partial vulvectomy, involving the removal of a portion of the vulva, is performed when necessary. This can entail the removal of either the inner or outer labia or the labia from one side only, depending on the location of the cancer. The surgical approach and the decision to perform lymph node dissection (removing lymph nodes) on one or both sides of the groin are based on the cancer's location. In cases where lymph nodes are removed from both sides of the groin, it is termed a triple incision vulvectomy, involving one incision for vulva removal and two additional incisions on each side for lymph node removal. You may have one or two wound drains placed in your groin to safely manage any accumulated blood or fluids. These drains are typically removed during a follow-up outpatient clinic visit two to three weeks later. Your anticipated hospital discharge following this procedure generally falls within the range of five to ten days.
Complete Vulva Removal (Radical Vulvectomy)
This surgical procedure is referred to as a radical vulvectomy. It entails the complete removal of the entire vulva, encompassing both the inner and outer labia, as well as the clitoris. Typically, lymph nodes from both sides of the groin are removed, a procedure known as lymph node dissection, often referred to as a triple incision vulvectomy. This involves one incision for vulva removal and two additional incisions on each side for lymph node extraction. Typically, two wound drains are placed in your groin to facilitate the safe drainage of any collected blood or fluids. You will return home with these drains and schedule a follow-up outpatient clinic visit two to three weeks later for their removal. Anticipated hospital discharge following this surgery typically ranges from five to ten days, although some patients may require a slightly longer hospital stay.
Sentinel Node Biopsy
In vulval cancer, the lymph nodes located in the groin are often the initial sites where cancer can potentially spread. Consequently, many women have a portion or all of these nodes removed during their surgical procedure. Subsequently, the removed lymph nodes are examined for the presence of cancer. It's important to note that the removal of lymph nodes can give rise to a condition known as lymphoedema, which we will discuss as a potential risk associated with vulval surgery.

To mitigate the risk of lymphoedema, you may be offered a sentinel node biopsy, which is a method for assessing lymph nodes for cancer without the necessity of complete removal. The sentinel node represents the first lymph node that receives fluid drainage from the vulva, making it the initial node that cancer could potentially spread to. If the sentinel nodes are found to be free of cancer, it is likely that no further lymph nodes contain cancer cells, obviating the need for additional removal.

To identify the sentinel node(s), the surgeon administers a small quantity of radioactive liquid near the cancer site on the morning of the operation. During the surgery, blue dye is injected into the same area. The sentinel nodes are those that exhibit a blue stain and uptake of the radioactive liquid. These nodes are subsequently extracted and subjected to cancer cell testing. If the sentinel nodes are clear of cancer cells, there is generally no requirement for further lymph node removal. However, if cancer cells are detected in one or more sentinel nodes, additional treatment will be necessary.

Still have questions?

Can’t find the answer you’re looking for? Please chat to our friendly team.

Surgery for Vaginal Cancer

The choice of surgery you require is contingent upon the stage of your vaginal cancer. The stage provides information regarding the size of the cancer and the extent of its spread, as well as its specific location within your vagina.

It's important to note that your surgeon may not be able to determine the precise stage of your cancer until after the surgical procedure has been completed.
Wide Local Excision
When the cancer is relatively small, a wide local excision is typically recommended. This surgical approach entails the removal of the cancerous area along with a margin of healthy tissue surrounding it. In some cases, this procedure may also involve the removal of lymph nodes from the groin on the same side as the cancer, known as lymph node dissection. The duration of your hospital stay following this operation can range from one to three days, depending on the extent of the surgery.
Vaginectomy
A surgical procedure to excise the upper portion of the vagina is referred to as a partial vaginectomy. Conversely, a total vaginectomy is a procedure that involves the complete removal of the entire vagina. The choice between these two operations depends on the extent of vaginal involvement by the cancer.

For early-stage cancers situated in the upper part of the vagina, it's common to remove all or a portion of the affected vaginal tissue. In addition, your physician typically removes the uterus and cervix, along with the lymph nodes on both sides of your pelvis. If you have previously had your uterus or cervix removed, the surgery primarily involves the removal of the vaginal portion and pelvic lymph nodes.

In some cases, your doctor may recommend vaginal reconstruction after a vaginectomy. This reconstructive surgery entails using skin and muscle from other parts of your body to fashion a new vagina. It's essential to understand that this procedure may not be suitable for everyone, and some individuals may opt not to undergo this additional surgery.
Radical Hysterectomy
A hysterectomy is a surgical procedure that involves the removal of the uterus (womb) and its neck (cervix). In the case of vaignal cancer, the vagina will be removed entirely, also. Typically, both the fallopian tubes and ovaries are also removed in a bilateral salpingo-oophorectomy. Additionally, it may be necessary to extract certain pelvic glands, known as lymph nodes. In some cases, a small tissue sample, referred to as a biopsy, might be obtained from other lymph nodes located in your abdominal region.

This surgery is performed under general anaesthesia, ensuring that you are unconscious throughout the procedure. The primary objective of this surgery is the complete eradication of the cancer. If there is any indication that the cancer has spread, additional treatments such as radiotherapy or chemotherapy may be proposed. The decision on further treatment will be discussed with you once all your test results are available.

A hysterectomy will remove your ability to get pregnant. It is important to decide whether this is important for you before proceeding with surgery.

Hysterectomy can be performed through multiple approaches which will result in different scarring. The approaches we offer at Gynae Health Clinic include abdominal hysterectomy, laparoscopic (keyhole) hysterectomy, and robotic hysterectomy.

Still have questions?

Can’t find the answer you’re looking for? Please chat to our friendly team.

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