[Operative laparoscopy in gynecology oncology]

Because of the poor sensitivity and accuracy of noninvasive nonsurgical methods of detection of occult pelvic and para-aortic lymph nodes, as well as the cost and discomfort of surgical staging, Keelung Chang Gung Memorial Hospital introduced laparoscopic procedures in the staging of cervical cancer from May 1992. Since then, 112 such surgical procedures have been undertaken, including 36 pelvic lymphadenectomies, 20 para-aortic lymphadenectomies, 6 infrarenal paraaortic lymphadenectomies, 22 simple hysterectomies, 6 extended hysterectomies, 2 Schauta's radical hysterectomies, 4 omentectomies, 5 appendectomies, 3 ovarian transpositions, and 8 second look operations for ovarian cancer. All patients tolerated the procedures smoothly except for one who had hemostasis. There was also one complication of tumor seeding at the laparoscopic skin site. Our preliminary experience shows the feasibility and safety of laparoscopic procedures for gynecology and oncology patients. The potential application of laparoscopy in managing gynecologic malignancies is highly appreciated in our institute. The birth of operative laparoscopy in the subspecialty of gynecologic oncology has taken place.