- For Appointment:
- +91 63590 11009
- Chat on Whatsapp
Where the robot helps in cervical cancer, and where open surgery is still the safer choice. Planned and done by Dr Swati Shah at Apollo Hospital, Bhat, Gandhinagar.
Send your biopsy report, MRI and PET scan on WhatsApp. We read them before you arrive. · +91-89800-20898
Dr Swati Shah
MS, DrNB (Surgical Oncology)
Robotic Cancer Surgeon (Urology & Gynec) · Apollo Hospital, Bhat, Gandhinagar · Gota OPD, Ahmedabad
Shah’s Gastro, Cancer & Robotic Surgery Centre. Trained at busy cancer centres. Fully qualified in cancer surgery. 18 years of experience in cancer surgery for women. Rated 4.9 from 53 Google reviews at the Gota clinic, and 5.0 from 25 at Apollo Hospital, Bhat.
Last updated: 10 October 2026
We use the robot in cervical cancer for small, low-risk tumours, for lymph node checks and to move the ovaries before radiation. Larger tumours have open surgery.
The robot is used for four jobs here. Each one has strict rules. A tumour of 2 cm or more needs a radical operation, and that is done open.
Robotic surgery is a form of keyhole surgery. The surgeon sits at a console. The robot holds the camera and the tools. The view is in 3D and made bigger. The tools bend like a wrist. This helps deep in the pelvis, close to the bladder, the ureters and the nerves.
But in cervical cancer, the route is not chosen by liking. It is chosen by trial results. So the robot does some jobs and not others. The table shows where we use it.
| The job | Who it is for | Approach here |
|---|---|---|
| Simple hysterectomy with sentinel nodes | Small, low-risk cancer that meets the SHAPE rules. | Robotic. |
| Sentinel node or pelvic node check | Early cancer, to see if it has reached the glands. | Robotic. |
| Moving the ovaries (ovarian transposition) | Young women with squamous cancer who need pelvic radiation. | Robotic. |
| Staging before treatment | When scans leave a doubt about the glands or spread. | Robotic. |
| Radical hysterectomy | Tumour of 2 cm or more, or not low-risk. | Open, nerve-sparing. |
| Larger or spread cancer | Stage IB3 and above. | Chemoradiation, not surgery. |
The LACC trial found that keyhole or robotic radical hysterectomy led to more deaths than open surgery. So we do every radical hysterectomy open.
This is the most important fact on this page. In the LACC trial, women had a radical hysterectomy for early cervical cancer. Half had it by keyhole or robot. Half had it open. At four and a half years, 90.6 in 100 women were alive after keyhole or robotic surgery. After open surgery, 96.2 in 100 were alive. The cancer also came back more often after keyhole surgery. The final report of the trial confirmed this.
Two causes are thought likely. A tool called a uterine manipulator is pushed into the cervix to move the womb. It can press on the tumour. And when the vagina is cut open with gas in the belly, cancer cells may spill. Doing keyhole surgery “carefully” does not undo the trial result. So for a radical hysterectomy, we use a cut on the belly. We do not offer robotic radical hysterectomy for cervical cancer.
The open operation we do is a nerve-sparing radical hysterectomy, called Type C1. We remove the womb, the cervix, the tissue beside the cervix and the top of the vagina. We save the nerves that run the bladder. This helps you pass urine on your own after surgery.
If your cancer is small and low-risk, a simple hysterectomy with a node check is as safe as a radical one. We do this by robot.
The SHAPE trial asked a key question. For small, low-risk cancer, is a smaller operation enough? The answer was yes. A simple hysterectomy with a check of the pelvic glands kept the cancer away as well as a radical one at three years. Women had fewer bladder problems. Their sex life was better too.
A simple hysterectomy removes the womb and cervix, but not the tissue beside the cervix. It is a smaller operation. Because the risk is low, the robot can be used. To be low-risk, every one of these must be true:
The selection is the operation. A 2.5 cm tumour is not nearly 2 cm. If one rule is not met, you are not in the low-risk group. Then the plan changes to open radical surgery, or to chemoradiation. We explain why in plain words, with your scans on the screen.
When we use the robot, we never use a uterine manipulator. We close the vagina over the tumour before cutting, so cancer cells cannot spill.
The LACC trial taught us what to avoid. So two safety steps are fixed rules in every robotic operation on the cervix here.
A green dye shows the first lymph node on each side of the pelvis. We remove that node and test it, instead of removing all the glands.
Cervical cancer spreads first to the lymph glands in the pelvis. The sentinel node is the first gland the cancer would reach. If that gland is clear, the others are very likely clear too.
At the start of surgery, we put a dye called ICG into the cervix. The robot has a near-infrared camera. It shows the dye glowing green as it flows to the first gland on each side. We remove these glands. They go for a quick test, called a frozen section, while you are asleep.
The SENTICOL III trial was published in October 2025. It showed that removing only the sentinel nodes is as safe as removing all the pelvic glands, when the sentinel nodes are clear on frozen section. Women had much less leg swelling, called lymphoedema. After all the glands are removed, 15 to 25 women in 100 get leg swelling. After sentinel nodes alone, it is 5 to 10 in 100.
Two rules make this safe. If one side does not light up, we remove the glands on that side. An unmapped side is an unchecked side. And we ask the lab for a detailed test called ultrastaging. It finds very small deposits. It is not done unless we ask for it, so we always ask.
If you are young and need pelvic radiation, the robot can move your ovaries up and out of the beam. This can protect your natural hormones.
Larger cervical cancers are treated with chemoradiation, not surgery. Radiation to the pelvis stops the ovaries working. That brings on menopause at once, even in a woman of 30. Hot flushes, weak bones and dryness can follow.
An ovarian transposition is a short keyhole operation. We lift each ovary out on its own blood supply. We place it high in the belly, away from the radiation field. We mark it with a small clip so the radiation team can see it. With the robot, this needs only small cuts. Radiation can start soon after.
It suits women before menopause with squamous cancer. In adenocarcinoma, the cancer can spread to the ovary more often, so we usually do not move them. Moving the ovaries protects hormones, but it does not keep the chance of a baby after radiation to the womb. If you want children, tell us before any treatment starts. That talk must come first.
Sometimes the MRI and PET scan do not settle the stage. A gland may look borderline. Or the plan between surgery and chemoradiation depends on the glands. In these cases, a robotic look and gland removal can give the answer. We do it only when the result will change your treatment.
We also avoid one trap. If scans suggest the cancer has reached the glands or the tissue beside the cervix, we do not plan a radical operation followed by radiation. Having both gives the side effects of both, with no gain in cure. In that case we go straight to chemoradiation.
Robotic surgery means smaller cuts, less blood loss and a stay of one to two days. Open surgery means a longer stay but is safer for radical hysterectomy.
| Point | Robotic | Laparoscopic (keyhole) | Open |
|---|---|---|---|
| Cuts | A few small cuts. | A few small cuts. | One cut on the lower belly. |
| Blood loss | Low. | Low. | More. |
| Hospital stay | One to two days, typical. | One to two days, typical. | Four to five days, typical. |
| Back to daily life | Sooner. | Sooner. | Slower, as the wound heals. |
| View and tools | 3D, magnified, wristed tools. | Flat or 3D screen, straight tools. | Direct view by eye. |
| Use in cervical cancer here | Low-risk simple hysterectomy, nodes, ovary move, staging. | Same limits as the robot. | All radical hysterectomies. |
The robot’s magnified view helps most where the work is fine. That means finding small glands along the pelvic blood vessels. It means seeing the ureter and the bladder nerves clearly. And it means moving an ovary without harming its blood supply.
| Robotic surgery may suit you if | Robotic surgery is not for you if |
|---|---|
| Your tumour is under 2 cm and meets every SHAPE rule. | Your tumour is 2 cm or more. You need open radical surgery or chemoradiation. |
| You need a sentinel node or pelvic node check. | Scans show the cancer has spread to the glands or beyond the cervix. |
| You are young, have squamous cancer and need pelvic radiation. | Your cancer is adenocarcinoma and the plan is to move the ovaries. |
| Your scans leave a doubt that surgery can settle. | You have stage IB3 or higher. Chemoradiation is the treatment. |
★★★★★
“My mother was treated for cervix cancer 5 years ago by Dr. Swati Shah (Gynec Oncologist). She is highly skilled, explains everything clearly, and provides very compassionate care. Thanks to her expertise, my mother is doing well today. Highly recommended.”
Meena Yadav, March 2026
More stories are on the Dr Swati Shah page.
The cost depends on the operation, the approach and the days in hospital. Robotic surgery adds a charge for the robot. ICG dye and ultrastaging add a little more. A shorter stay can save some of this. The Apollo Hospital, Bhat, insurance desk arranges cashless approval where your policy allows. Bring your insurance card, policy papers and photo ID to your first visit. See our page on cashless cancer treatment through insurance.
It depends on the operation. For radical hysterectomy, the LACC trial found more deaths after keyhole or robotic surgery, so we do it open. For small low-risk cancer, node checks and moving the ovaries, the robot is used with strict safety steps.
Only if it is low-risk. The tumour must be under 2 cm, 10 mm deep or less, with no LVSI and normal glands on scans. Then a robotic simple hysterectomy with sentinel nodes is an option.
Because the trial results are clear. A tumour of 2 cm or more needs a radical hysterectomy. Done open, it gave better survival than keyhole or robotic surgery. We choose the route by the evidence, not by the tool we own.
It is the first gland that cancer would spread to. A green dye and a special camera show it. If it is clear, the other glands are very likely clear too. This spares you a full gland removal and lowers the chance of leg swelling.
Often, yes, if you are young and have squamous cancer. A short robotic operation moves the ovaries out of the radiation field. This can prevent early menopause. It does not keep the chance of pregnancy.
Most women go home one to two days after robotic surgery. After an open radical hysterectomy, the stay is usually four to five days. You leave only when your bladder empties well.
Visits at the Gota OPD, Ahmedabad. Surgery at Apollo Hospital, Bhat, Gandhinagar.
Swasth Parivar: twice a month, practical advice on recovery, diet and warning signs. No advertising. Stop any time.
Your number is used for these updates and for the clinic to reach you. It is never sold or passed on. To stop, reply STOP on WhatsApp.
