Robot-assisted laparoscopic trachelectomy after supracervical hysterectomy

Area of Science:

• Gynecologic Oncology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Persistent pelvic pain and bleeding after hysterectomy indicate complex gynecological issues.
• Previous surgical attempts for hysterectomy were unsuccessful, highlighting the need for advanced techniques.
• Severe endometriosis and adhesions pose significant challenges in gynecological procedures.

Observation:

• A 40-year-old female with a history of severe endometriosis and adhesions presented with refractory symptoms post-hysterectomy.
• The patient had undergone a supracervical hysterectomy with prior failed attempts at laparoscopic-assisted vaginal hysterectomy and total abdominal hysterectomy.
• Robot-assisted laparoscopic trachelectomy was performed to address the persistent symptoms and associated pelvic disease.

Findings:

• The robot-assisted laparoscopic trachelectomy was completed successfully without intraoperative or postoperative complications.
• Minimal blood loss was observed during the procedure.
• At 10 months follow-up, the patient experienced complete symptom resolution and was in good health.

Implications:

• Robotic surgery can effectively bridge the technical gap between open laparotomy and standard laparoscopy for complex trachelectomies.
• This approach may offer a less invasive alternative for patients with extensive pelvic adhesions and endometriosis.
• Successful robot-assisted procedures can lead to improved patient recovery and symptom management in challenging gynecological cases.