THE ROLE OF LAPAROSCOPIC SURGERY IN GYNECOLOGIC ONCOLOGY

As a result of recent technological advances, laparoscopic lymphadenec tomy is becoming the standard method for the staging of pelvic cancer. More extensive procedures, such as para-aortic lymph node dissection and radical hysterectomy, have also been demonstrated to be feasible b y advanced laparoscopic surgery. This new approach appears to be very promising. In the future, because of its well documented advantages, l aparoscopic surgery may appear as a way to decrease the morbidity of c ancer treatment in patients with low-risk tumors and to propose more a ggressive treatments of patients with tumors associated with a poor pr ognosis. These new techniques should be reserved for surgical teams tr ained in oncologic and major laparoscopic surgery. More clinical resea rch is required before this approach can be proposed as an alternative to laparotomy, and guidelines have to be established. Training in onc ology is essential to ensure optimal patient care and to avoid the con sequences of inadequate laparoscopic management with regard to cases o f tumor dissemination reported after laparoscopic biopsy or resection of undiagnosed ovarian cancer.