This week, doctors at Hillel Yaffe Medical Center performed a surgical procedure that has only been performed a handful of times in Israel - surgical removal of the cervix, while preserving the uterus of the patient with cervical cancer. The surgery was performed on a woman of about 30, who was diagnosed with cervical cancer, and for whom the surgery offered a real possibility of recovery and preservation of fertility. In this procedure, the cervix is removed in full, and the body of the uterus is connected directly to the vagina. Additionally, full removal of the pelvic lymph nodes is performed.
Prof. Laszlo Ungar, an internationally acclaimed physician from Budapest, Hungary, was invited to assist with the surgery. He is a specialist in this surgical method, which is complex and unique. The senior staff of the Gynecology Department participated in the surgery: Dr. Ilan Bruchim, Director of the Gynecology and Gynecologic Oncology Unit at Hillel Yaffe Medical Center and Chairman of the Israeli Society of Gynecologic Oncology, and Dr. Shmuel Anderman, Senior Gynecological Surgeon.
"Surgical removal of the cervix is not a common procedure for women diagnosed with cervical cancer," said Dr. Ilan Bruchim. He added, "The incidence of cervical cancer is relatively low in Israel, with about 200 new patients a year. The standard treatment for women diagnosed with cervical cancer includes full removal of the uterus, lymph nodes or radiation and chemotherapy. However, it is obviously impossible to become pregnant after these treatments. Therefore, the procedure we performed is only offered to women with early stage cervical cancer with a small tumor (less than 2 centimeters), who want to preserve their fertility. That is why it is a relatively rare form of surgery in Israel."
"Beyond the fact that a great deal of expertise is required to perform the surgery," said Dr. Bruchim, "There are very few women who are suitable candidates. Experience with this surgery in Israel is also limited. Prof. Ungar has been invited to assist on most of the surgeries performed to date in Israel. As far as we're concerned, performance of the surgery at our facility is also important so we can learn the technique and be able to perform it on our own in the future. However, it's also so that we can offer our patients a surgical option with a low rate of side effects and excellent rate of recovery."
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The team during surgery. From right to left: Dr. Shmuel Anderman,
Prof. Lazlo Ungar and Dr. Ilan Bruchim
The woman who had surgery this week at Hillel Yaffe is a young woman who was diagnosed with cancer at a relatively early stage, in an exam performed at a clinic in the community. She was brought to the Gynecology-Oncology Unit at Hillel Yaffe for continued investigation and treatment. After in-depth testing, which included a cervical biopsy and imaging, the diagnosis was verified. Because she told Dr. Bruchim that she wanted to preserve fertility and to become pregnant in the future, the possibility of performing the surgery for removal of the cervix was the best option for her.
"In the past, to enable recovery from cervical cancer, particularly in early stages, it was standard to perform a full hysterectomy and remove the cervix," said Dr. Bruchim. "In recent years, physicians have started using a complex surgical technique, in which the cervix is removed and the body of the uterus is connected directly to the vagina. In this manner, the uterus is preserved, and a woman who has undergone the surgery can become pregnant and give birth via cesarean section."
As previously stated, experience in these types of procedures in Israel is limited and the surgery is performed on very rare occasions. Even in the rest of the world, it is generally only performed at large medical centers. Prof. Lazlo Ungar is considered the world's leading surgeon for this procedure, and several medical centers in Israel have used his services.
The Gynecology Oncology Unit opened its doors at Hillel Yaffe Medical Center close to two years ago as part of the Gynecology and Obstetrics Department. It provides an oncological response for all areas of treatment and works in conjunction with the medical center's Oncology Unit and with specialists in various fields, as needed.
"In the unit, it is important for us to offer women the optimal solutions for their disease," summed up Dr. Bruchim. "I, Mimi Gellman the coordinating nurse and our entire staff worked as a cohesive team, as did the administration, which immediately stepped in to bring Prof. Ungar to Israel to perform the procedure. As far as I'm concerned, this is yet another way we can create a uniform, supportive and professional environment for any woman who needs it."
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