A 26-year-old nulliparous woman with stage IB1 (< 2 cm) squamous cell carcinoma of the cervix wishes to preserve fertility. Which surgical procedure is the fertility-preserving standard of care?

• A Radical trachelectomy (Dargent procedure) ✓
• B Large loop excision of the transformation zone (LLETZ)
• C Simple trachelectomy
• D Conisation only

Explanation

Radical trachelectomy (Dargent procedure) — removal of the cervix, upper vagina, and parametria with pelvic lymph node dissection while preserving the uterine corpus — is the accepted fertility-sparing surgery for stage IB1 (< 2 cm) cervical carcinoma in women who desire future fertility. LLETZ and conisation are only appropriate for pre-invasive or microinvasive disease. Simple trachelectomy does not include parametrial removal and is inadequate for invasive disease.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.