Precision and progress: minimally invasive surgery in gynecologic cancer treatment

ABSTRACT

Minimally invasive surgery (MIS), which comprises laparoscopy, robotic surgery, and vaginal transluminal natural endoscopic surgery (vNOTES), has gained notoriety in the setting of many gynecologic diseases, including endometrial, ovarian, and cervical cancers. Over the years, several studies have conducted comparisons between MIS and laparotomic surgery. The predominant aspects of these techniques include less intraoperative bleeding, shorter hospitalization, accelerated postoperative recovery and lower incidence of peri- and postoperative adverse events. However, costs and operative time remain high. Articles comparing different minimally invasive surgical procedures for the management of gynecologic cancer were reviewed. Although several articles have pointed out that the use of the surgical approach by MIS has not shown substantial differences in survival compared with laparotomy and has manifested excellent peri- and postoperative outcomes for endometrial cancer, the relevance of minimally invasive surgery for cervical and ovarian cancer remains controversial. Incipient indications suggest laparoscopic cytoreduction as an emerging procedure for appropriately selected patients following neoadjuvant chemotherapy treatment. Several scientific evidence have attested to the improved clinical parameters associated with the adoption of a minimally invasive surgical approach compared with open procedures. The preeminent goal of minimally invasive surgery should aim at optimizing oncologic outcomes and improving the health status of patients.