abstract: Role of Minimally Invasive Surgery in Staging of Ovarian Cancer

Abstract

OPINION STATEMENT:
Since the introduction of laparoscopy and robotic surgery in gynecologic practice in the last several decades, use of these minimally invasive surgical techniques has increased dramatically. The role of minimally invasive surgical techniques continues to expand because they offer reduced intraoperative and postoperative complications, less intraoperative blood loss, and a shorter postoperative recovery. Despite initial concerns about the use of minimally invasive surgery in gynecologic oncology, this approach has been shown to be safe and effective in the management of uterine and cervical cancer, and minimally invasive surgical management of these malignancies is now commonplace. Concerns remain regarding the use of minimally invasive surgery for the staging and management of ovarian cancer, including concerns regarding the adequacy of abdominal exploration and staging with minimally invasive approaches compared to traditional laparotomy and the risks and implications of intra-operative tumor cyst rupture and port-site metastases. However, several case series, retrospective reviews, and case-control studies have demonstrated that minimally invasive surgery is both safe and effective for the staging of borderline ovarian tumors and early-stage epithelial ovarian cancer when performed by a trained gynecologic oncologist. Data to support the role of minimally invasive surgery for advanced epithelial ovarian cancer are scant and use of minimally invasive surgery in this setting is not recommended.

media: Robot-assisted surgery better and cheaper, studies suggest (minimally invasive surgery)

Single-port risk-reducing salpingo-oophorectomy with and without hysterectomy: Surgical outcomes and learning curve analysis

OBJECTIVE:
Based on considerable prospective data, risk-reducing salpingo-oophorectomy (RRSO) is one of the most beneficial interventions available to reduce ovarian/breast cancer risk in BRCA carriers and high-risk women. The purpose of this study was to describe the initial surgical outcomes and learning curve analysis associated with laparoendoscopic single-site (LESS) RRSO with and without hysterectomy.

RESULTS:
A total of 58 patients were evaluated; 36 (63%) were BRCA1/2 carriers and 38 (63%) had breast cancer.

"Prospective studies are needed to assess the relative benefits of LESS compared with more conventional minimally invasive approaches."