ABSTRACT
Advances in surgical management among the solid tumors have developed in response to a variety of catalysts over the years. One of these has been the pursuit of surgical precision—balancing maximal survival against morbidity of therapy. This relatively recent concept derives from a combination of an improved understanding of disease biology and the identification of effective adjuvant therapies, which have allowed modification of traditional surgical paradigms and procedures. Lymphatic mapping and sentinel node identification represents one of these advances, which among diseases such as malignant melanoma and breast cancer have radically altered classic surgical practices once deemed “the final achievement of surgery.” Integration of lymphatic mapping into triage and management has dramatically improved treatment precision by offering better disease characterization with the potential for reduced toxicity through less radical intervention. The purpose of this chapter is to introduce the concept of lymphatic mapping and sentinel node identification as it is being developed among the gynecologic cancers and to report on the early, albeit promising, experience, particularly in vulvar and cervical malignancy.
