Robotic-Assisted Laparoscopic Fertility Sparing Surgery for Treatment of Early-Stage Cervical Cancer

Abstract

<h3>Study Objective</h3> To explore the safety, feasibility and pregnancy outcome of da Vinci robotic-assisted laparoscopic fertility-sparing surgery for early-stage cervical cancer. <h3>Design</h3> Retrospectively review clinical data of 10 patients who underwent robotic-assisted radical trachelectomy with bilateral lymphadenectomy between January 2018 and February 2020 in our center. <h3>Setting</h3> N/A. <h3>Patients or Participants</h3> The mean age of the 10 patients was 29.6±3.0 years old and the mean BMI was 23.9±3.7 kg/m². Among them, 1 patient was in stage IA1 with lymph-vascular space invasion, 2 patients in stage IA2 and 7 patients in stage IB1. <h3>Interventions</h3> N/A. <h3>Measurements and Main Results</h3> The average operative time was 295±21 min. The average estimated amount of intraoperative blood loss was 65±18 ml, and the average number of lymph nodes removed was 28.6±3.5. The length of parametrial tissue removed on the left side was 34.3±1.6 mm and 33.9±1.5 mm on the right side. No intraoperative complications occurred. Postoperatively, the length of cervix (measured by transvaginal ultrasound) was 7.1±1.7 mm. The average length of hospital stay was 7.7±2.0 days. The median follow-up was 23.9 months. One patient had lymphocele 2 months after the operation. No recurrence happened during the follow-up period. Three patients achieved pregnancy, including 2 natural pregnancy and 1 assisted-reproductive pregnancy. One woman with natural pregnancy 11 months postoperatively delivered a healthy female infant at 38⁺¹ weeks. <h3>Conclusion</h3> Robotic-assisted radical trachelectomy is a safe and feasible alternative for cervical cancer patients who desire fertility preservation. Its long-term oncologic outcome and pregnancy outcome require further investigation.