Oncosurgery through punctures
Laparoscopy in gynecological oncology is the standard for endometrial cancer: magnification allows for precise identification of lymph nodes (selectively - signal and enlarged groups), the uterus is removed through the vagina without morcellation in a container, washouts and revision are performed fully. Advantages: minimal blood loss, early activation (important for the prevention of thrombosis in cancer patients), rapid transition to adjuvant treatment if necessary. Selection of patients is strict: uterine size, stage, histotype; The decision is made by the oncoconsilium.
Indications
- cervical cancer IA2–IIA — radical hysterectomy with pelvic lymph node dissection (Wertheim procedure);
- endometrial cancer - extirpation with appendages and lymph node dissection according to risk;
- ovarian cancer - cytoreductive interventions as part of complex treatment;
- vaginal cancer - radical removal with lymph node dissection;
- atypical hyperplasia with impossibility of organ preservation.
Principles of radical surgery
Oncological gynecological surgery differs from a conventional hysterectomy in volume: the tumor is removed with surrounding tissues (parameters, vaginal cuff) and lymphatic drainage pathways as a single block - this is the radicality that determines the prognosis. The number and condition of removed lymph nodes stages the disease and resolves the issue of postoperative radiation/chemotherapy. The price categories reflect the complexity: involvement of neighboring organs, the need for ureteral stenting, prevalence. The operations are performed by a gynecological oncology team with high-level anesthesiological support.
