Total Hysterectomy

• Removal of the uterus and cervix

Radical Hysterectomy

• Removal of the uterus, cervix, upper vagina, and surrounding tissues
• Usually combined with lymph node removal

Commonly Recommended For:

• Cervical cancer
• Endometrial (uterine) cancer
• Selected early gynecologic cancers

Surgical Approaches:

• Open surgery
• Laparoscopic surgery
• Robotic-assisted surgery

Advantages of Minimally Invasive Surgery:

• Smaller incisions
• Less postoperative pain
• Faster recovery
• Shorter hospital stay

Commonly Performed Along With:

• Hysterectomy in ovarian and endometrial cancers

Indications:

• Ovarian cancer
• Fallopian tube cancer
• Advanced uterine cancer
• Preventive surgery in high-risk patients

Purpose:

• Remove the source of cancer
• Reduce risk of cancer spread or recurrence

Procedure:

Removal of:

• Ovaries and fallopian tubes
• Uterus
• Omentum (fatty abdominal tissue)
• Visible tumor deposits within the abdomen

Goal:

• Remove as much tumor as possible (“optimal cytoreduction”)

Importance:

• Better outcomes are associated with minimal residual disease after surgery

May Include:

• Bowel resection
• Diaphragm surgery
• Lymph node removal in advanced cases

Procedure:

Removal of lymph nodes for:

• Cancer staging
• Detecting spread
• Treatment planning

Commonly Performed In:

• Cervical cancer
• Endometrial cancer
• Ovarian cancer

Benefits:

• Helps determine cancer stage accurately
• Guides need for chemotherapy or radiation therapy

Procedure:

• The first draining lymph node (“sentinel node”) is identified and removed.
• If free of cancer, extensive node removal may be avoided.

Advantages:

• Smaller surgery
• Reduced risk of leg swelling (lymphedema)
• Faster recovery

Commonly Used In:

• Early endometrial cancer
• Selected cervical cancers

Procedure:

• A cone-shaped portion of the cervix is removed.

Benefits:

• Preserves fertility in selected young patients
• Diagnostic and therapeutic in early disease

Procedure:

• Removal of uterus, cervix, surrounding tissues, upper vagina, and lymph nodes

Goals:

• Complete cancer removal
• Prevent local spread

Common Procedure:

• Total hysterectomy
• Bilateral salpingo-oophorectomy
• Sentinel node biopsy or lymph node dissection

Often Performed Minimally Invasively:

• Laparoscopic or robotic-assisted surgery is commonly used

Benefits:

• Faster recovery
• Reduced blood loss
• Less postoperative pain

Procedures Include:

• Wide local excision
• Partial vulvectomy
• Radical vulvectomy in advanced cases

May Be Combined With:

• Groin lymph node surgery

Goals:

• Complete tumor removal
• Preservation of urinary and sexual function whenever possible

Procedure:

May involve removal of:

• Uterus
• Cervix
• Bladder
• Rectum
• Surrounding pelvic organs

Indications:

• Recurrent cervical or pelvic cancer not responding to other treatments

Purpose:

• Curative treatment in carefully selected patients

Advantages:

• Smaller incisions
• Reduced pain
• Faster recovery
• Less blood loss
• Earlier return to normal activities

Commonly Used For:

• Endometrial cancer
• Early cervical cancer
• Selected ovarian tumors