Current status of operative laparoscopy in gynecologic oncology.

The role of laparoscopy in gynecologic oncology has expanded in the last few years to include a variety of situations and cancers. Patients with invasive cervical carcinoma can be spared radical hysterectomy if laparoscopy documents positive lymph nodes. Therapeutic laparoscopic pelvic lymphadenectomy has been performed successfully in patients with small cervical lesions. Laparoscopy can be used for staging in patients with advanced cervical cancer who are scheduled for definitive radiotherapy. Laparoscopically assisted surgical staging is also feasible, safe, and adequate in patients with clinical stage I endometrial cancer, and is being investigated in patients with stage I ovarian cancer. Second-look laparoscopy is proving useful in ovarian cancer patients who are candidates for a second-look procedure. Laparoscopic pelvic lymphadenectomy is being investigated in patients with small stage I vaginal carcinoma who are being considered for treatment with brachytherapy alone.