Trachelectomy (Cervix Removal)
Trachelectomy (Cervix Removal)
A Trachelectomy (Cervix Removal) is the surgical removal of the cervix, which is the neck of the uterus. This surgery can be done before a hysterectomy for issues related specifically to the cervix. Younger women may choose trachelectomy over hysterectomy as a means of treating a specific condition while preserving fertility for a future pregnancy.
Before the Procedure
Your physician will also conduct a full physical exam—including blood and imaging tests—on you and your partner to determine your candidacy. One particular test is called a hysterosalpinogram (HSG), which uses dye and X-rays, or saline and air with ultrasound, to examine the length and performance of your remaining fallopian tubes.
Always tell your health care provider or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.
During the days before the surgery:
- You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), and any other drugs that make it hard for your blood to clot.
- Ask your health care provider which drugs you should still take on the day of your surgery.
On the day of your surgery:
- You will very often be asked not to drink or eat anything for 6 – 12 hours before the surgery.
- Take the drugs your health care provider told you to take with a small sip of water. Your health care provider or nurse will tell you when to arrive at the hospital.
FAQS
Frequently asked questions about surgical procedures
Can I use my insurance and get these prices?
Payment is due 14 calendar days prior to your surgery date. If, after the cutoff, your account is not settled, your case must be postponed.
How quickly can I have surgery?
How will I meet my surgeon?
If I had a car or work accident, would you work with my employer or attorney for payment?
What if I get sick right before my surgery?
You could develop a respiratory infection, a urinary tract infection, COVID, or some other condition that may necessitate postponement. There is no penalty when this happens.
What’s Included:
- Facility fee
- Graft and hardware costs (if needed)
- Surgeon and assistant surgeon fees
- Anesthesiologist
- Time in the recovery unit (at no additional charge)
- Initial consultation visit
- One post-operative visit
*Please note: If you choose not to proceed with surgery after the initial consultation, or if you delay your procedure for more than 6 weeks, you will need to update your consultation at a cost of $375.
What’s not included:
- Lab testing before and after the surgery, as needed
- Electrocardiogram (EKG), depending on age. If you had one elsewhere in the past 6 months and it read “normal”, we can forego this expense.
- Imaging costs. X-rays and MRIs can be obtained anywhere.
- Physical therapy services
- Medications you’ll need (oral or IV antibiotic infusions if an infection arises)
- Wound care
- Bracing supplies
- Additional doctor visits (a pre-operative visit with the surgeon, in person, and any required post-op follow-ups after the suture removal to monitor your progress
- Additional surgical intervention if a complication arises
- Additional imaging or hospital care if a blood clot develops
Trachelectomy (Cervix Removal) Procedure
During a Trachelectomy (Cervix Removal), the surgeon removes the cervix, the upper part of the vagin, and some of the tissue around the cervix. The rest of the uterus is left in place. The surgeon may use different approaches to do a Trachelectomy:
- Vaginal Radical Trachelectomy (VRT) removes the cervix and the nearby tissue through the vagina. VRT is the most commonly used approach.
- Abdominal Radical Trachelectomy removes the cervix and nearby tissue through the abdomen.
- Laparoscopic Radical Trachelectomy uses a thin, tube-like instrument with a light and lens (called a laparoscope). The surgeon makes small incisions, or surgical cuts, in the abdomen. The laparoscope and other instruments are passed through the small incisions into the abdomen to remove the cervix and nearby tissues.
At the end of the surgery, the surgeon uses a special stitch (called cerclage) to partially close the opening of the uterus where the cervix used to be. This opening allows the flow of menstrual blood during the woman’s period. A temporary catheter may be placed in the opening to help keep it from closing.
The cervical tissue that is removed during surgery is examined under a microscope to see if there are any cancer cells. If there are cancer cells at the edge of the removed tissues (called positive surgical margins), the surgeon may try to remove more tissue. In some cases, the surgeon may need to do a hysterectomy to make sure that all of the cancer is removed.
What to expect after your surgery
After a Trachelectomy (Cervix Removal)
If a catheter is placed in the artificial opening between the vagina and uterus, it will be removed about 3 weeks after the surgery.
Follow-up after a Trachelectomy will usually include sampling tissue at the site of surgery (similar to a Pap test procedure) and a Colposcopy, every 3–4 months for the first 2–3 years after surgery.
Risks
All surgeries carry risks. Trachelectomy (Cervix Removal), while rare, complications may include:
- Bleeding
- Infection
- Deep vein thrombosis, or swelling of the legs
- Vaginal discharge
- Allergic reaction to anesthesia and medication
- Bladder and urination problems
- Painful sexual intercourse
Can I Travel to St George for Surgery?
Yes, and we’ll help you make all your arrangements.
- We have arrangements to try to obtain free flights through a non-profit volunteer pilot organization. We can do this with 10 days’ advance notice in most cases.
- We have discount codes for the Holiday Inn in town. This hotel is 1.5 miles from the surgery center and 2 miles from our clinic.
- We’ll arrange to send your after-surgery medications to your hometown pharmacy for pickup before you leave.
What if I would rather drive to St George?
No problem, we can help with those plans as well. When you have surgery with us, we’ll need to make sure you’re safe and comfortable after surgery. We’ll arrange cold compression therapy that requires an AC/DC adaptor/transformer and frequent stops to stretch and refill the ice reservoir on the road.
We’ll ask about the vehicle you’ll travel in to ensure you have a way to elevate and stretch out in the vehicle on the road while someone else does the driving.
How are follow-up and initial consultations handled?
In-person and telehealth consultations are possible with the surgeon to whom your case is assigned. The initial visit is included in the surgical package and is valued at $375.
We can also obtain the flights from the volunteer pilot nonprofit if you’d like to come for initial and follow-up visits in person. One follow-up visit is included in the surgical package at a value of $175. Any additional visits are charged at the time of service to your credit or debit card.
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