Abstract
Background: Cervical cancer is the fourth greatest cause of mortality among female cancers worldwide. Young women with early-stage cervical cancer (FIGO IA1-IB1) and low risk can preserve their reproductive possibilities through alternate surgical treatments. They allow, with minimal risk, to treat the disease with a good prospect of getting pregnant and carrying the pregnancy. Conization, simple trachelectomy, and radical trachelectomy can all be done vaginally, abdominally, or with minimally invasive techniques (laparoscopic or robotic surgery). This case series investigates the effectiveness of robotically assisted treatments in preserving reproductive potential in women with early-stage cervical cancer. Material and methods: This study examined five women aged 33 to 44 who had early-stage cervical cancer and received fertility-sparing treatment between March 2022 and March 2024. Patients at Saint Marina University Hospital in Pleven underwent both simple standard and robot-assisted trachelectomy with pelvic lymph node dissection. Results: Key outcomes measured were operative time, hospital stay, intraoperative and postoperative complications, and reproductive success. There are no intraoperative complications. One early postoperative complication was registered uncomplicated lymphocele. The operative time for robot-assisted tachelectomies is 105 and 120 minutes, respectively and a hospital stay of 4 days. The simple trachelectomies show an operative time between 30 and 45 minutes and a hospital stay of 2 days. No abnormal blood loss was seen. Two pregnancies were reported among patients, one conceived naturally and one with ART. There were no cancer recurrences reported throughout follow-up periods ranging from 3 to 24 months. Conclusion: Fertility-sparing surgery had good oncological and reproductive outcomes for patients with early-stage cervical cancer. These findings emphasize the importance of specialist surgical expertise in clinical practice and point to its potential for widespread use.

Key words: case series, early-stage cervical cancer, fertility-sparing surgery, reproductive outcomes, oncological outcomes, surgical complications