Why stents
The ureters pass a centimeter from the cervix through the parametrium, the main area of radical excision; the stent makes the ureter palpable and visible along its entire length, insuring the most common risk of gynecological oncology. Indications: tumor larger than 4 cm, infiltration of parametria, adhesions after surgery/inflammation, condition after irradiation. Installation adds 15–20 minutes; postoperative discomfort from stents is moderate, removal is outpatient. The rest of the operation and recovery are the same as in category I.
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.
