Essential surgical skills for a gynecologic oncologist

Abstract

Gynecologic oncology has seen a tremendous growth as a surgical specialty over the past four decades. However, many regions of the world still lack structured training programs in this discipline. The aim of this article is to identify the essential skills for a gynecologic oncologist to be able to provide optimal care to women diagnosed with gynecologic cancer. Where the evidence exists in the literature we identify the learning curve necessary. Identifying essential skills required for the practice of gynecologic oncology should assist in standardizing care provision globally, and could be a starting point for health systems beginning structured training programs. Development of surgical skills requires adequate training, mentorship, and self‐evaluation as an ongoing process beyond the years spent in training programs.

Effect of Quality Control Program in Surgical Management of Early Cervical Cancer

“…Various quality improvement systems to optimize clinical outcome and patient safety have been adapted to health care system, and measures of “quality” can be quantified by using different indicators. 3 4 5 Traditionally, quality of care has been evaluated from 3 different levels: structure, process, and outcome. 2 6 Structural indicators of quality include environmental features of care, such as trained personnel, hospital facilities, and equipment.…”

“…It has been clear, that the quality and extent of surgery influence the perioperative complications, overall morbidity, local tumor control and eventually, recurrence and survival. 2 3 4 In other gynecologic cancers including ovarian cancer, it has been proved that the clinical outcome was superior when treated in quality controlled, specialized institution, by specialists. 3 5 This is possibly due to appropriate preoperative judgment, accurate diagnosis, optimal surgical technique as well as effective postoperative care.…”

Training for next-generation gynaecologic surgical & radiation oncologists – opportunities & challenges

“…Surgical intervention is often the first step in diagnosis, staging and treatment in gynaecological cancer 14 . The increasing burden of cancer in India provides opportunities for GO training.…”

“…The options can be in the form of a two-year fellowship or super-speciality with a DM degree in gynaecologic oncology and brachytherapy 35 . A similar programme is now established by starting a MCh in gynaecologic oncology 14 .…”

Extrapelvic bowel resection and anastomosis in cytoreductive surgery for ovarian cancer

“…Contemporary data suggest that the amount of postoperative residual tumor is the most significant factor for the survival of patients with advanced ovarian cancer (1,2). Ovarian cancer frequently invades the small and large intestines, making bowel resection a crucial part of cytoreductive surgery (1,(3)(4)(5)(6). As tumors invade multifocal areas of the bowel serosa and mesentery without clear boundaries, gynecologic oncology surgeons often need to make intraoperative decisions regarding the extent of bowel resection, taking into consideration the preservation of bowel function and technical feasibility.…”