Pregnancy After Cervical Cancer Surgery
New Technique Preserves Womb, Allows Delivery by C-Section
Del Priore tells WebMD that there are two ways to surgically remove the cervix. "It can be done vaginally, which was the method originally proposed, or it can be done by abdominal surgery, as we did in this study," he says.
Trachelectomy, which is the medical term for surgical removal of the cervix, was re-introduced to the world of gynecologic surgery in the mid-1990s by Daniel Dargent, MD, of Lyon, France. At the time, the procedure was roundly criticized by U.S. surgeons. "It was embarrassing. They made fun of his accent. But I heard that first report and thought he had something," recalls Del Priore.
Del Priore says he learned the vaginal procedure and began offering it to women who wanted to preserve fertility. "But even though the vaginal surgery is a good operation in skilled hands, it is a difficult procedure to learn," he says. At that point he realized that he could perform trachelectomy by modifying a familiar operation -- in this case, hysterectomy. "This procedure is very easy for any gynecologic surgeon. I literally have people call me and I can walk them through it on the phone," he says.
Joan Walker, MD, the Brian and Sandra O'Brien Presidential Professor and chief of gynecologic oncology at the University of Oklahoma Health Sciences Center in Oklahoma City, tells WebMD that young gynecologists are actually quite adept at performing the procedure using the vaginal technique, although older surgeons might have difficulty learning to do it. But she thinks the new procedure may be especially useful for women who have larger tumors since "we can only do the vaginal surgery with small lesions."
Walker agrees that attitudes about trachelectomy have changed considerably. "Now we think of Dargent as a hero," she says.