05: Retroperitoneal anatomy and parametrial dissection in robotic uterine-artery sparing radical trachelectomy

Abstract

To review retroperitoneal and parametrial anatomy, demonstrate surgical techniques for retroperitoneal and parametrial dissection, and describe obstetric outcomes of uterine artery-sparing radical trachelectomy. A 29-year old with stage 1B1 adenosquamous carcinoma of the cervix underwent uterine artery-sparing robotic-assisted radical trachelectomy, upper vaginectomy, excision of bilateral pelvic sentinel lymph nodes, excision of left internal iliac node, and cerclage placement. The parametrial dissection was performed with robotic assistance, while the colpotomy, trachelectomy, and cerclage were performed transvaginally to minimize contamination to the peritoneal cavity. Minimally-invasive trachelectomy has benefits of decreased blood loss and less recovery time, and attempts to spare the uterine artery should be considered in patients desiring fertility preservation.