Wertheim–Meigs operation

Wertheim–Meigs Operation

Illustration of a radical hysterectomy procedure

The Wertheim–Meigs operation is a type of radical hysterectomy that is primarily used in the treatment of early-stage cervical cancer. This surgical procedure involves the removal of the uterus, surrounding tissue, the upper part of the vagina, and the pelvic lymph nodes. It is named after the Austrian gynecologist Ernst Wertheim and the American surgeon Joe Vincent Meigs.

History

The Wertheim–Meigs operation was first developed in the early 20th century. Ernst Wertheim performed the first radical hysterectomy in 1898, and his technique was later modified and popularized by Joe Vincent Meigs in the mid-20th century. The procedure was a significant advancement in the surgical treatment of cervical cancer, offering a potential cure for patients with early-stage disease.

Indications

The Wertheim–Meigs operation is indicated for patients with early-stage cervical cancer, typically stages IA2 to IIA, where the cancer is confined to the cervix and has not spread to distant sites. It may also be considered in certain cases of endometrial cancer and other gynecological malignancies.

Procedure

The procedure involves several key steps:

• Anesthesia: The patient is placed under general anesthesia.
• Incision: A vertical or transverse incision is made in the abdomen to access the pelvic cavity.
• Removal of the Uterus: The uterus is carefully dissected and removed along with the cervix.
• Excision of Surrounding Tissue: The parametrium, which is the tissue surrounding the uterus, is excised.
• Vaginal Resection: The upper part of the vagina is removed.
• Lymphadenectomy: Pelvic lymph nodes are removed to assess for the spread of cancer.

Complications

As with any major surgical procedure, the Wertheim–Meigs operation carries risks of complications, including:

• Infection
• Bleeding
• Injury to surrounding organs such as the bladder or rectum
• Lymphedema due to lymph node removal
• Urinary dysfunction

Recovery

Recovery from a Wertheim–Meigs operation can take several weeks. Patients are typically advised to avoid heavy lifting and strenuous activity during the recovery period. Follow-up care is essential to monitor for any signs of cancer recurrence and to manage any long-term side effects of the surgery.

Related Pages

• Cervical cancer
• Radical hysterectomy
• Ernst Wertheim
• Joe Vincent Meigs
• Pelvic lymphadenectomy