Techniques in Gynecologic Oncology

Gynecologic oncologists have been performing various minimally invasive procedures for some time for ovarian, uterine, and cervical cancers. Minimally invasive procedures may be used for radical hysterectomy, pelvic and para-aortic sentinel lymph node biopsy or complete lymphadenectomy, and omentectomy. Although most associate radical hysterectomy with cervical cancer, para-aortic lymphadenectomy with uterine cancer, and omentectomy with ovarian cancer, these procedures may be used for any gynecologic malignancy. Some patients may undergo more than one of these minimally invasive techniques. Minimally invasive radical hysterectomy should no longer be utilized for early-stage cervical cancer but may be employed for clinical stage II uterine cancer. For apparent early-stage ovarian cancer, a minimally invasive approach also seems adequate; however, for advanced disease, an open exploration and maximal effort at tumor debulking still remain the standard of care. Minimally invasive procedures unique to gynecologic oncology are described in this chapter.