From Radical Hysterectomy to Radical Surgery for Deep Endometriosis.

Abstract

Pelvic surgery is a study and art of the basic human anatomy; besides removing pathological organs and parts, it allows the study of pelvic anatomy through careful dissection of its structures. Radical pelvic surgery started about 120 years ago; it has progressively improved and evolved techniques to provide the best outcome for gynecological cancers. It started initially with a laparotomy approach of radical and debulking surgeries with complete systematic pelvic lymph node dissection, para-aortic lymph node dissection, and omentectomy. Since the 1990s with the introduction of minimally invasive surgery for gynecology diseases, the management of gynecological cancer has evolved into individualized treatment. It has made Minimally Invasive Surgery (MIS) the gold standard treatment for endometrial cancer. [1-5] Many doctors and researchers worldwide have a positive opinion regarding the MIS approach in treating cervical cancer;[6] it benefits fertility preservation, lower morbidity, and quicker recovery compared to open surgery.[7-10] The current trend for gynecological cancer is shifting toward the MIS approach; in developed countries, MIS for endometrial cancers has increased from 10% to more than 80%.[11]