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[Place of celiosurgery in the extensive diagnosis of gynecologic cancers]
D Querleu1, E Leblanc, B Castelain
1Service de Chirurgie Gynécologique-Cancérologie, Pavillon Paul-Gellé, Roubaix.
Abstract:
Laparoscopic surgery occupies an increasingly important place in the diagnosis and staging of gynaecological cancers. It allows repeated complete investigation of the abdomen and retroperitoneum: macroscopic examination of the peritoneum, cytology, biopsies, infracolonic omentectomy, appendicectomy, pelvic and para-aortic lymphadenectomy, without interfering with therapeutic procedures (simple or radical hysterectomy) which can be associated. In cancers of the endometrium, it is part of a surgical strategy associating vaginal hysterectomy. In ovarian cancers, it is essentially applied to restaging of insufficiently explored apparent stage I tumours. In operable cervical cancer, it guides the therapeutic protocol and surgical indication by allowing interiliac lymphadenectomy. In advanced cervical cancers, it is used to detect para-aortic lymph nodes.