Surgery for Gynaecological Cancers

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.

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.

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.

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.

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.

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.

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.

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.