Gynaecological Cancer Surgery

Gynaecological cancer surgery treats cancers of the womb lining (endometrium), ovaries and fallopian tubes, cervix, vulva and vagina. It is performed by gynaecological oncologists, surgeons with additional training in cancer operations of the pelvis and abdomen. The operation differs considerably depending on the organ and stage.

For womb and early cervical cancer, surgery is frequently the main treatment. For ovarian cancer the goal is to remove all visible disease, generally combined with chemotherapy. Surgery stages the cancer accurately, and the final pathology decides whether radiotherapy or chemotherapy should follow.

What Gynaecological Cancer Surgery involves

After biopsy, MRI or CT and tumour board review, the operation is tailored. For endometrial cancer the womb, cervix, tubes and ovaries are removed, usually by keyhole surgery, and sentinel lymph nodes are identified with a fluorescent dye and removed. For early cervical cancer, a radical hysterectomy removes the womb with the tissue beside the cervix and the upper vagina, plus pelvic nodes; current evidence favours an open approach for this operation. For ovarian cancer, a long midline incision allows removal of the ovaries, womb, omentum and every visible deposit, which may include segments of bowel, the lining of the diaphragm or the spleen. Vulval cancer is treated with wide local excision and groin sentinel node biopsy.

Who is a good candidate for Gynaecological Cancer Surgery?

The plan depends on the cancer type, stage, your wish for future pregnancy and your general health.

• Endometrial cancer at almost any operable stage
• Cervical cancer at early stages, usually up to 4 cm and confined to the cervix
• Ovarian, tubal and peritoneal cancer, as primary surgery or after 3 cycles of chemotherapy
• Vulval cancer
• Women carrying BRCA or Lynch syndrome genes who are considering risk-reducing removal of tubes, ovaries or womb
• Selected young women with early disease suitable for fertility-sparing surgery

Es ist normalerweise nicht die richtige Wahl, wenn:

• Locally advanced cervical cancer, which is treated with chemoradiotherapy instead of surgery
• Widespread ovarian cancer where imaging or laparoscopy shows that complete removal is not achievable, until chemotherapy has been given
• Women too frail for major abdominal surgery
• Pre-cancerous cervical changes, which need only a small local excision

Technikoptionen

• Total hysterectomy with sentinel node mapping: Keyhole or robotic; standard for endometrial cancer.
• Radical hysterectomy: For early cervical cancer, performed as an open operation in line with trial evidence.
• Cytoreductive (debulking) surgery: Extensive open surgery for ovarian cancer, aiming to leave no visible tumour.
• Fertility-sparing surgery: Cone biopsy or trachelectomy for very early cervical cancer, or removal of a single ovary for selected early ovarian tumours.
• Vulval excision with groin sentinel node biopsy: Limits the extent of groin surgery and the risk of leg swelling.
• HIPEC: Heated chemotherapy washed through the abdomen at interval debulking surgery in selected ovarian cancer; practice varies between centres.

Was passiert während Ihrer Behandlung

Keyhole hysterectomy for womb cancer takes 1.5 to 3 hours with 1 to 3 nights in hospital. Open radical hysterectomy takes 3 to 4 hours with a stay of 4 to 6 nights. Ovarian debulking can take 4 to 8 hours, often with a night or more in intensive care and 7 to 14 days in hospital. All are performed under general anaesthetic, often with an epidural after open surgery.

Vorbereitung auf Ihre Reise

Plan for 2 to 4 weeks in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stoppen Sie das Rauchen und Nikotin mindestens vier Wochen vor und nach der Operation; es ist die größte vermeidbare Ursache von Wundproblemen
• Erzählen Sie dem Team von allen Medikamenten und Ergänzungen, die Sie einnehmen; Blutverdünner, einige Kräuterprodukte und Hormonbehandlungen müssen möglicherweise auf Anraten Ihres Arztes unterbrochen werden
• Vereinbaren Sie, dass jemand mit Ihnen reist oder erreichbar ist, und halten Sie die ersten Tage zu Hause frei von Arbeit und Heben
• Buchen Sie einen veränderlichen Rückflug; Ihr Chirurg bestätigt, wenn Sie fit sind

Genesung und Ergebnisse

After keyhole surgery most women resume light activity in 2 weeks and return to work in 4 to 6 weeks; after open surgery it takes 6 to 12 weeks. A urinary catheter may remain for some days after radical hysterectomy while bladder nerves recover. Removal of the ovaries before the menopause causes immediate menopausal symptoms; whether hormone replacement is safe depends on the type of cancer. Pathology takes 1 to 2 weeks. Any adjuvant radiotherapy or chemotherapy begins about 4 to 6 weeks after surgery.

• Back to everyday activity: 4 to 12 weeks
• When results show: Pathology in 1 to 2 weeks
• How long they last: Follow-up for about 5 years

Sicherheit, Risiken und Revisionspolitik

The risks rise with the extent of surgery and are highest for ovarian debulking.

• Bleeding that needs transfusion
• Infection of the wound, pelvis, urine or chest
• Blood clots in the legs or lungs, for which preventive injections continue for 4 weeks
• Injury to the bladder, ureters or bowel, and occasionally the need for a temporary stoma
• Bladder emptying problems after radical hysterectomy
• Lymphoedema of the legs after lymph node removal
• Surgical menopause and loss of fertility
• Hernia, adhesions and changes to sexual function

Jeder schriftliche Vorschlag wird durch Clinic-Y gibt an, was die Klinik abdeckt, wenn eine Korrektur erforderlich ist. Fragen Sie danach, bevor Sie buchen, nicht danach.

Cost of Gynaecological Cancer Surgery in Türkiye

Clinic-Y does not publish a single price for Gynaecological Cancer Surgery, because the honest figure depends on your case. What moves it:

• The type and extent of operation
• Keyhole, robotic or open approach
• Intensive care and length of stay
• MRI, CT or PET-CT staging, and pathology including molecular tests
• Any additional bowel surgery, HIPEC or adjuvant treatment

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