Fertility preservation is a procedure of conservative surgery which may be performed in the early stage of cervical cancer as radical trachelectomy. The aim of the study is to describe the first robotic radical trachelectomy in Poland with safe cervical sample extraction using an underpressure manipulator. Robotic abdominal trachelectomy was performed in a 42-year-old nullipara with squamous cell cervical carcinoma G2 using an underpressure manipulator. No complications were observed. Mobilization of the patient began the day after the surgical procedure. The long-term obstetric and oncologic outcome of this technique would be expected to match the outcome of the other radical trachelectomy techniques in the published literature. Using of an underpressure manipulator decreases the risk of cervical tumour spread during the surgery. To our knowledge, this is the first description of safe radical trachelectomy specimen extraction using an underpressure colpotomizer.