The role of laparoscopy in gynecologic oncology

Abstract

In some patients and when performed by a skillful surgeon, gynecologic oncologist familiar with advanced laparoscopic techniques, laparoscopy results with less surgical trauma, reduced blood loss and hospitalization, and faster recovery. The complication rate has been found to increase as the complexity of the operation rises, but it is not higher than in open surgery. Preliminary studies show that recurrence and survival rates are comparable to those reported for patients treated by a standard abdominal approach. Future randomised trials are necessary to deal with long term recurrences and survival data and benefits of laparoscopy in management of gynecologic malignancies. At our institution 97 cancer patients underwent laparoscopic procedures, without complications: explorative and staging laparoscopies with biopsies of ovaries, peritoneal biopsies, retroperitoneal and mesenteric tumours; second look laparoscopy, ovariectomy, laparoscopic assisted vaginal hysterectomy (LAVH). Advanced ovarian cancer was found in 3 patients and laparotomy was performed. No complications were established.

Rectosigmoid sparing en bloc pelvic resection for fixed ovarian tumors: Surgical technique and perioperative and oncologic outcomes

“…Several studies in the past have also demonstrated a significant discrepancy between the CT and the surgical findings on bowel involvement ( 16 , 30 , 31 ). In the past decades, a few groups have introduced an exploratory laparoscopy (EXL) before laparotomy ( 32 – 35 ). The advantages of EXL are multiple, including a correct diagnosis based on the histology of tissue biopsy, precise evaluation of disease spread, and better selection of the patients for ultra-radical surgery.…”