The Gynaecological Oncology and Laparoscopic Surgery Unit has been operating since 2011 at St. Luke's Hospital. The Unit aims at the prevention, early diagnosis and treatment of patients with benign and malignant neoplasms of the female genital tract, as well as patients with recurrence-relapse of previously treated gynaecological cancer.

What is gynaecological oncology?

One of the most important problems for the modern woman is the possibility of developing a malignant disease (cancer) in the genitals, such as:

• Breast cancer
  
• Ovarian cancer
  
• Fallopian tube cancer
  
• Uterus cancer
  
• Uterus cervix cancer
  
• Vaginal cancer
  
• Vulvar cancer

Gynaecological Oncology has been established as the medical specialisation of Obstetrics-Gynaecology, which deals with the pathology of the female genital system and the prevention, early diagnosis and treatment of gynaecological cancer. The aim of gynaecological oncology is also to improve the quality of healthcare provided to cancer patients.

Cervical cancer

Frequency and mortality rates

Indicatively, it is reported that cervical cancer is a cause of death for about 30,000 women in Europe and 250,000 women around the world, while in our country it affects every year 500-600 women, mainly young women, who have not had children, and 200 to 250 of these women lose their lives every year.

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Unit and human resources

The treatment of patients is always within the framework of cooperation (in the sense of an oncology council) with colleagues of other medical specialties, such as:

• Pathologists
• Biopathologists
• Molecular Biologists
• General Surgeons
• Radiodiagnosis doctors
• Radiotherapists
• Pathologists-Oncologists

Thanks to the interdisciplinary collaboration of the above medical specialties, various cancers are diagnosed early and treated with the appropriate treatment.

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Philosophy of the Gynaecological Oncology and Laparoscopic Surgery Unit

In the Gynaecological Oncology and Laparoscopic Surgery Unit, our main goal is safety and the best possible oncology result for each patient. These are ensured by the laparoscopic approach, combined with minimal postoperative pain and faster mobilization and return to daily activity for each woman.

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Main oncological gynaecological procedures

The main oncological gynaecological operations performed are the following:

• Total laparoscopic radical hysterectomy with the method of preservation of neural plexuses (Nerve-sparing) with lymphadenectomy.
• Total laparoscopic hysterectomy with the ICG method with lymphadenectomy.
• Total laparoscopic hysterectomy after the Appendages.
• Laparoscopically assisted radical vaginal trachelectomy with lymphadenectomy.
• Radical Vulvectomy with lymph node cleansing and plastic reconstructive rehabilitation.
• Debulking surgery for ovarian, uterus, fallopian tube, peritoneum cancer.

Innovations in the Gynaecological Oncology Unit

An innovation offered in the Gynaecological Oncology Unit concerns the possibility of a laparoscopic approach in cases of surgical treatment of benign, but mainly malignant diseases of the cervix, endometrium, uterus and, in limited cases, the fallopian tubes and ovaries. This laparoscopic approach is applied either for the treatment of the disease or for its staging, i.e. the confirmation of its stage and extent. Also, in its effort to apply the most modern technology, the Gynaecological Oncology Unit, in March 2020, for the first time in Greece, carried out the removal of a sentinel lymph node using the IMAGE1 S™ RUBINA K.Storz system.

Range of incidents we face

We can treat all cases of gynaecological cancers. In fact, endometrial and cervical cancer are treated laparoscopically.

• Endometrial cancer. The innovative method of detecting a sentinel lymph node with the use of ICG is carried out. It is performed laparoscopically, with minimal postoperative pain and immediate mobilisation of the patient in the first twenty-four hours.

• Cervical cancer. In specific cases, Laparoscopic Radical Hysterectomy is performed with preservation of the visceral nerves. This operation is very demanding and is performed in very few centres in Europe. In addition, we perform laparoscopic removal of lymph nodes from the pelvis and aorta, where necessary.

• Ovarian cancer. It is treated with open surgery (laparotomy) to achieve complete removal of all foci (volume reduction). The success of the first operation is a very important factor for the survival of patients and the effectiveness of complementary therapies (chemotherapy).

Prevention and early diagnosis of gynaecological cancer

The Unit offers and performs the following tests, per organ, for the prevention and early diagnosis of gynaecological cancer:

• Vulva and vagina. HPV vaccine, clinical examination, vulvoscopy, colposcopy, biopsies and diagnostic procedures.
• Cervix. HPV vaccine, clinical examination, Pap test, HPV DNA test, colposcopy, biopsies and diagnostic procedures.
• Endometrium and uterine body. Clinical examination, transvaginal ultrasound, imaging tests, diagnostic curettage, diagnostic hysteroscopy and hysteroscopic operations.
• Fallopian tubes and ovaries. Clinical examination, transvaginal ultrasound, serial measurements of molecular markers in the blood, imaging tests and diagnostic laparoscopic procedures.

In particular, with regard to diseases related to infection of the external genital organs by the human papillomavirus (HPV), the following are offered:

• Detection, diagnosis and treatment of HPV-induced lesions.
• Assessment, evaluation and treatment of a pathological Pap test.
• Assessment, evaluation and treatment of a positive HPV DNA test.
• Advice on infection with the papillomavirus (HPV).
• Advising and carrying out the vaccine against HPV.

In addition to the above, the Unit offers advisory guidelines for the prevention of gynaecological cancer, especially for groups of patients with the burden of hereditary diseases.

Early examination contributes decisively to the detection of the disease in a precancerous or even early-stage of cancer, so that the treatment is much easier and with much better results in terms of prognosis.