Laparoscopic Assisted Surgical Staging (LASS) for Endometrial Cancer

We report the first four cases of LASS for endometrial cancer in Mexico. Four patients diagnosed with endometrial adenocarcinoma were selected. These patients underwent peritoneal washing, vaginally assisted laparoscopic hysterectomy, bilateral salpingo-oophorectomy and pelvic biopsies. These biopsies included dissection of common iliac vessel, hypogastric and external vessels, and obturator nerve. An average of 10 nodes were obtained (8-11). In all patients both the nodes and the peritoneal washings were negative. The pathologic surgical staging was: three patients with IBG2 and one patient with IAG2. The patients were discharged on the sixth postoperative day, without complications. The follow-up is of 1 to 7 months and all are alive and without tumor activity. Patients with endometrial cancer often have associated obesity, diabetes and hypertension. For this reason the practice of minimally invasive surgery reduces morbidity. However, a full knowledge of anatomy, oncologic gynecology, and operative laparoscopy is imperative.