Minimal access surgery in gynecologic cancer: we can, but should we?

Operative laparoscopists continue to refine surgical techniques applicable to patients with gynecologic malignancies. Various techniques for radical hysterectomy and larger series of patients with endometrial cancer have now been reported. The technical feasibility of such operations is being established. Although oncologic patients may enjoy the known benefits of laparoscopic surgery, such as shorter hospitalization, the known shortcomings, such as longer operative times and increased cost, are a concern. The unknown shortcomings and the unknown overall survival of laparoscopically managed patients continue to keep the majority of oncologic surgeons a safe distance away.