This guide will tell you how to prepare for your radical trachelectomy surgery at Memorial Sloan Kettering (MSK), including what to expect before and after your surgery.
About Your Surgery
A radical trachelectomy is a surgery that removes the cervix (the end of your uterus that opens into your vagina) and nearby tissue (see Figure 1). You may be having a radical trachelectomy because you have cervical cancer. With this surgery, the remainder of your uterus is left in your body, which may allow you to have children in the future. However, you should see a fertility specialist before your surgery to discuss your options for pregnancy in the future.
Before Your Surgery
You will have an appointment for presurgical testing (PST). The date, time, and location of your PST appointment will be printed on the appointment reminder from your surgeon’s office.
You can eat and take your usual medications the day of your PST appointment. During your appointment, you will meet with a nurse practitioner who works closely with anesthesiology staff (specialized doctors and nurses who will be giving you medication to put you to sleep during your surgery).
Your nurse practitioner will review your medical and surgical history with you. You will have tests, including an electrocardiogram (EKG) to check your heart rhythm, a chest x-ray, blood tests, and any other tests necessary to plan your care. Your nurse practitioner may also recommend you see other healthcare providers.
Your nurse practitioner will talk with you about which medications you should take the morning of your surgery.
It is very helpful if you bring the following with you to your PST appointment:
- A list of all the medications you are taking, including patches and creams.
- Results of any tests done outside of MSK, such as a cardiac stress test, echocardiogram, or carotid Doppler study.
- The name(s) and telephone number(s) of your doctor(s).
You will also get resources called Getting Ready for Surgery, Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs), and Herbal Remedies and Cancer Treatment. These resources have more instructions about how to prepare for your surgery.
A clerk from the Admitting Office will call you after 2:00 pm the day before your surgery. The clerk will tell you what time you should arrive for your surgery. If you are scheduled for surgery on a Monday, you will be called on the Friday before. If you do not receive a call by 7:00 pm, please call 212-639-5014.
On the day of your surgery, go to:
MSK Presurgical Center (PSC)
1275 York Avenue (between East 67th and East 68th Streets) New York, NY
B elevator to 6th floor
You may need to follow a clear liquid diet the day before your surgery. A clear liquid diet includes only liquids you can see through. Examples are listed in the table below. You cannot eat any solid foods while on a clear liquid diet. Your nurse will tell you if you need to follow a clear liquid diet.
Do Not Drink
Sweets and Desserts
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The Day of Your Surgery
Between midnight and up until 2 hours before your scheduled arrival time, you may drink a total of 12 ounces of clear liquids (see Figure 2).
Examples of clear liquids include:
- Clear broth, bouillon, or consommé (no particles of dried food or seasonings)
- Gelatin, such as Jell-O®
- Clear fruit juices (no pulp), such as white cranberry, white grape, or apple
- Soda, such as 7-Up®, Sprite®, ginger ale, seltzer, or Gatorade®
- Coffee or tea, without milk or cream
- Take only the medications your doctor told you to take the morning of your procedure. Take them with a few sips of water.
- Do not put on any lotion, cream, powder, make-up, or perfume.
- Remove all jewelry, including body piercings.
- Leave all valuables, such as credit cards and jewelry, at home.
- If you wear contacts, wear your glasses instead.
- A list of the medications you take at home
- Your rescue inhaler (such as albuterol for asthma), if you have one
- A case for your glasses
- Your Health Care Proxy form, if you have completed one
Parking at MSK is available in the garage on East 66th Street between York and First Avenues. To reach the garage, enter East 66th Street from York Avenue. The garage is located about a quarter of a block in from York Avenue, on the right-hand (north) side of the street. There is a tunnel that goes from the garage into the hospital. For questions about prices, call 212-639-2338. There are also commercial garages nearby on East 69th Street between First and Second Avenues and on East 65th Street between First and Second Avenues.
You will be asked to state and spell your name and date of birth many times. This is for your safety. People with the same or similar names may be having surgery on the same day.
A nurse will meet with you before your surgery. Tell your nurse him or her the dose of any medications (including patches and creams) you took after midnight and the time you took them.
Once your nurse has seen you, 1 or 2 visitors can keep you company as you wait for your surgery to begin. When it is time for your surgery, your visitor(s) will be shown to the waiting area.
You will walk into the operating room or you can be taken in on a stretcher. A member of the operating room team will help you onto the operating bed. Compression boots will be placed on your lower legs. These gently inflate and deflate to help circulation in your legs. You may also have a blood pressure cuff and EKG pads to monitor you during surgery.
Your anesthesiologist will place an intravenous (IV) line into a vein, usually in your arm or hand. The IV line will be used to give you fluids and anesthesia (medication to make you sleep) during your surgery.
Once you are fully asleep, a breathing tube will be placed through your mouth and into your windpipe to help you breathe. You may also have a urinary catheter placed to drain urine from your bladder.
Your surgeon will first examine your pelvic area to make sure that there is no cancer outside of your cervix. To do this, your surgeon will make 1 large incision (surgical cut) or several small incisions. Your surgeon will first examine your abdomen, the organs in your pelvis, and your lymph nodes. If no cancer is visible outside of your cervix, your lymph nodes will be removed and tested for cancer.
If there is no cancer in your lymph nodes, your surgeon will continue your radical trachelectomy. A large portion of your cervix and tissue around it will be removed. The rest of your uterus will be left in place and sutured (stitched closed) so it can support a future pregnancy (see Figure 3). Most women will continue to have their periods after the surgery.
Once your surgery is finished, your incisions will be closed Steri-StripsTM (thin pieces of tape) or Dermabond® (surgical glue) and covered with a dry dressing. Your breathing tube is usually taken out while you are still in the operating room.Back to top
After Your Surgery
When you wake up after your surgery, you will be in the Post-Anesthesia Care Unit (PACU).
You will receive oxygen through a thin tube that rests below your nose called a nasal cannula.
You may have a urinary catheter (Foley®) in your bladder to monitor the amount of urine you are making. It will stay in place for 1 to 2 weeks after your surgery. Your nurse will teach you how to care for it. You may have a pain pump called a patient-controlled analgesia (PCA) device. For more information, please read Patient-Controlled Analgesia (PCA).
Your visitors can see you briefly in the PACU, usually within 90 minutes after you arrive there. After your stay in the PACU, you will be taken to your hospital room in the inpatient unit. Your nurse will tell you how to recover from your surgery.
You can shower 24 hours after your surgery.
Most people are in the hospital for 3 days after their surgery.
- You will get a prescription for pain medication. Take your medication as directed and as needed. Do not drive or drink alcohol while you are taking prescription pain medication.
- You can resume driving 2 weeks after your surgery, as long as you’re not taking any prescription pain medication.
- You may have vaginal bleeding or spotting for 4 weeks after your surgery. This is normal. Call your doctor if you having heavy vaginal bleeding.
- Do not do any strenuous activity (e.g., running, aerobics) until your first appointment after your surgery.
- Do not place anything inside your vagina (e.g., tampons, douches) or have vaginal intercourse until your first appointment after surgery. At this appointment, your doctor will tell you when you can resume having vaginal intercourse and using tampons.
- A temperature of 100.4° F (38° C) or higher
- Pain that is not relieved with prescription pain medication
- Heavy vaginal bleeding
- Blood in your urine
- Any questions or problems you did not expect
Your doctor will see you in 1 to 2 weeks after your surgery. The urinary catheter will be removed at this visit. Your doctor will give you the results of your pathology report and tell you if you need more treatment, such as surgery, chemotherapy, or radiation. You will need more treatment if:
- The cancer was not completely removed.
- Your surgeon thinks there is a high risk of the cancer coming back.
Your doctor will also discuss how this treatment may affect your ability to become pregnant.
At the end of treatment, you will need to have a Pap smear, a colposcopy, or both every 3 to 4 months for 2 years. You will then have them every 6 months.Back to top
We recommend that you use oral contraception (birth control) for 6 months. Do not try to become pregnant until 6 months after your surgery or the end of your treatment. Speak with your doctor before you try getting pregnant.
You may need to see a fertility specialist to help you get pregnant. If you do get pregnant, you will need to be watched closely by your obstetrician during your pregnancy. There is a good chance you could go into early labor. Your baby will most likely be delivered by cesarean section.Back to top