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The Oncologist, Vol. 11, No. 8, 895-901, September 2006; doi:10.1634/theoncologist.11-8-895
© 2006 AlphaMed Press

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Gynecologic Oncology

Role of Minimally Invasive Surgery in Gynecologic Cancers

Alan C. Schlaerth, Nadeem R. Abu-Rustum

Gynecology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, USA

Key Words. Minimally invasive surgery • Laparoscopy • Gynecologic cancers

Correspondence: Nadeem R. Abu-Rustum, M.D., Memorial Sloan-Kettering Cancer Center, Gynecology Service, Department of Surgery, 1275 York Avenue, New York, New York 10021, USA. Telephone: 212-639-7051; Fax: 212-717-3214; e-mail: gynbreast{at}mskcc.org

The role of minimally invasive surgery in the management of gynecologic cancers continues to expand. Radical vaginal trachelectomy with laparoscopic pelvic lymphadenectomy has emerged as a safe, reasonable option for women with early-stage cervical cancer desiring fertility preservation. Similarly, laparoscopically assisted radical vaginal hysterectomy has been systematically described, is feasible, and can be offered to women with early-stage cervical cancer who do not desire future childbearing. In the treatment of early-stage endometrial cancer, the surgical approach of laparoscopic hysterectomy, peritoneal washings, and pelvic and para-aortic lymph node dissection, with or without an omentectomy, is being compared with the same surgery performed via laparotomy in the cooperative Gynecologic Oncology Group LAP 2 study, which has completed accrual, and appears to be a reasonable surgical option. In ovarian cancer, minimally invasive surgery has been incorporated to manage early-stage, advanced-stage, and recurrent disease, as well as second-look procedures. Hand-assisted laparoscopy has also recently been described in managing larger volume primary and recurrent gynecologic cancers. Extraperitoneal laparoscopy for para-aortic and pelvic lymph node dissections has been shown to yield adequate nodal counts and to be safe and feasible in the management of gynecologic cancers.




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A. N. Fader and P. G. Rose
Role of Surgery in Ovarian Carcinoma
J. Clin. Oncol., July 10, 2007; 25(20): 2873 - 2883.
[Abstract] [Full Text] [PDF]


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