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Call: 424-255-1340

Endometriosis and the Cervix: Radical Fertility Sparing Surgery for Stage IV Endo Excision & Certain Cancers

Precision Robotic Surgery for Advanced Stage IV Endometriosis Excision Surrounding the Cervix

Cervical Endo & Cancer

On a selective referral-only basis, Dr. Steve Vasilev offers extremely rare, advanced robotic surgery for severe cervix-involving disease. While many surgeons no longer perform minimally invasive robotic radical dissection around the cervix, Dr. Vasilev continues to do so — both for complex endometriosis or adenomyosis that obliterates normal anatomy, and in certain cervical cancer cases where a minimally invasive, robotic approach can safely reduce recovery time. If preserving fertility, anatomy, or function is possible, he employs modified radical techniques to do so.

Call: 424-255-1340

When Surgery Gets VERY Complex We Get Going

Some patients with endometriosis or adenomyosis have disease that extends into or around the cervix, parametria, ureters, bladder or rectum. In these cases:

• Anatomy becomes highly distorted, scar tissue is dense.... like concrete in some cases when diagnosis is delayed.
• Removing this disease requires highest level oncologic-level radical skills: parametrial dissection, ureter mobilization, radical hysterectomy and cervix preserving equivalents.
• Robotic surgery offers precision, better visualization, less blood loss, smaller incisions — which can lead to faster healing and less long‐term morbidity.

Dr. Vasilev is one of very few surgeons internationally with both the excisional endometriosis/adenomyosis skill set and radical minimally invasive robotic pelvic surgery to handle these cases.

About Cervical Endo & Ca

Types of Growths and Cervical Tumors

The cervix can have benign growths on it like polyps and endometriosis or uncommon adenomyosis growing from the uterus down to the cervix, or it can harbor certain types of pre-cancer and cancer.  Some are more aggressive than others, so a personalized treatment plan that fits you is crucial. 

  • Endometriosis behind, on and in the cervix tissue

  • Adenomyosis growing into the uterine cervix

  • Polyps involving the cervix and adding to subfertility

  • Pre-cancer dysplasia and cancer of the cervix

Endometriosis : Overlap With Pelvic & Cervical Diseases

Shared Molecular Defects

Endometriosis does NOT cause cervical cancer but there are molecular pathways that overlap, including cell proliferation pathways, survival (apoptosis), and immune evasion. Both diseases involve abnormal cell growth and a pro-inflammatory microenvironment that contributes to their progression.

Weak Immunity

Infection with various immune altering disease, immunosuppresive drugs or a generally bad lifestyle can cause your immune system to be less effective. This interferes with your body’s ability to clear the cancer causing HPV virus as well.

Cervical Evaluation

If cervical disease is suspected after an abnormal Pap, the first step is a thorough visual examination of your cervix through a speculum. This is like a Pap smear type of pelvic exam, except a lot more attention is focused on looking at the cervix and seeing if anything needs to be biopsied. A magnifying instrument called a colposcope is sometimes used to look for the best place to biopsy the cervix. If an area looks suspicious, a biopsy is performed and might use one of the following instruments or techniques, usually performed by your general gynecologist:

  • Punch biopsy: a special instrument is used to pinch off a small amount of the abnormal looking area

  • Endocervical curettage: a small scraping instument is used to scrape or brush tissue from the inside of the cervical canal

    If either the punch biopsy or endocervical curettage show precancer or cancer cells after the pathologist reviews the biopsy under a microscope, one of the following might be done:

  • LEEP: using a thin, electrical wire a larger area of the cervix is removed while limiting the bleeding using the electical current for cautery. This can often be done in the doctor’s office.

  • Cone biopsy: A cone biopsy uses a scalpel, is more involved and is usually done in a surgicenter or a hospital under general anesthesia.

Outcomes

Beyond beating a disease like endo or surviving cancer there is quality of life, which can be equally as important. To achieve the best quality of life after a diagnosis, a personalized treatment plan is crucial. The best treatment plan and surgical outcome depends on accurate evaluation and diagnosis. 
 

We start by focusing on you as an individual and not just on your disease. At our Center, we specialize in helping you plan out the best outcomes possible based not just on your diagnosis but also on your body, mind and spirit.