ABSTRACT
Applications o f laparoscopy in gynecologic oncology were slower to occur, given the complexity o f surgical procedures required to treat malignancy. However, by the late 1980s, case reports were emerging o f minimally invasive techniques used by gyne cologic oncologists. Assessment o f pelvic lymph nodes was the first major application o f laparoscopy in gynecologic oncology. In 1989, Dargent and Salvat described an extraperitoneal approach to pelvic lymph node sampling through a suprapubic inci sion.5 Their technique evolved rapidly to a transperitoneal laparoscopic approach and was combined with radical vaginal surgery in the management o f early cervical and endometrial carcinomas.6,7
Currendy, there are laparoscopic techniques used to diagnose and treat patients with early and advanced cervical, endometrial and ovarian malignancies. Patients afflicted with gynecologic cancers tend to be older and in poorer health and thus are more likely to benefit from the reduced blood loss, shorter hospital stay and faster healing achieved by a minimally invasive approach. However, in addition to showing that laparoscopic procedures are feasible, it is also necessary to show that laparoscopic cancer manage ment is equivalent from a recurrence and survival perspective. This section will review the most recent data on minimally invasive procedures used in the field o f gynecologic oncology. Additionally, it will address concerns specific to the practice o f laparoscopy in patients with cancer.
