ABSTRACT
One of the more recent applications of MIS has been in its utility in oncologic surgery. Traditionally, the surgical management of malignancy was based on the radical excision of the primary tumor and its potential routes of spread. Over the past few decades, oncologic surgeons have found themselves balancing surgical radicality with outcome, and diseases previously managed with radical excision are currently being managed with less radical techniques, without compromise in survival. Concomitant with this change in surgical philosophy was the acceptance of MIS as a viable means of accomplishing this modern surgical goal. Consistently, data have demonstrated that MIS is associated with a reduced length of hospital stay, shortened recovery, and decreased postoperative pain. However, a minimally invasive surgical approach is oen more challenging, resulting in longer operating time, increased operating room
(OR) cost, and the need for consideration of appropriate patient selection. Additionally, the lack of tactile sensation with MIS theoretically limits the surgeon’s ability to use palpation as a mechanism for evaluation of the full extent of the disease. e greatest risk with any new procedure, as it pertains to the treatment of patients with malignancy, is the potential negative impact on disease-free recurrence or overall survival. In this chapter, the applications of MIS in the management of women with ovarian carcinoma will be explored. Evaluation of a pelvic mass and the primary management of apparently early-stage disease, advanced-stage disease, and recurrent ovarian cancer will be described in detail. e indications, outcomes, limitations, and risks specic to MIS in the diagnosis and management of ovarian carcinoma will be evaluated.
