PLACE OF LAPAROSCOPIC SURGERY IN THE STAG ING OF GYNECOLOGICAL CANCERS

Laparoscopic surgery occupies an increasingly important place in the d iagnosis and staging of gynaecological cancers. It allows repeated com plete investigation of the abdomen and retroperitoneum : macroscopic e xamination of the peritoneum, cytology, biopsies, infracolonic omentec tomy, appendicectomy, pelvic and para-aortic lymphadenectomy, without interfering with therapeutic procedures (simple or radical hysterectom y) which can be associated. In cancers of the endometrium, it is part of a surgical strategy associating vaginal hysterectomy. In ovarian ca ncers, it is essentially applied to restaging of insufficiently explor ed apparent stage I tumours. In operable cervical cancer, it guides th e therapeutic protocol and surgical indication by allowing interiliac lymphadenectomy. In advanced cervical cancers, it is used to detect pa ra-aortic lymph nodes.