The Role of Minimally Invasive Surgery in Modern Gynecological Oncology: A Paradigm Shift

Original Research | 2026 | Volume 1 | Issue 1 | Page 11-16

1. Dr. Surbhi Sharma, Assistant Professor, Department of Gynecology, GMC, Murshidabad

2. Dr. Ankus Sharma, Assistant Professor, Department of Gynecology, GMC, Murshidabad

   
   

Abstract:

Background: Traditionally, radical cytoreductive surgery via laparotomy was the gold standard for gynecological malignancies. However, the advent of Minimally Invasive Surgery (MIS)—encompassing conventional laparoscopy and Robot-Assisted Surgery (RAS)—has revolutionized the surgical management of endometrial, cervical, and early-stage ovarian cancers.

Objective: This review evaluates the clinical efficacy, oncological safety, and patient-reported outcomes of MIS compared to open surgery in the treatment of gynecological cancers.

Methods: A systematic review of major clinical trials, including the LACC and SHAPE trials, was performed to compare surgical morbidity, recurrence-free survival (RFS), and overall survival (OS) across various surgical modalities.

Discussion: The primary advantages of MIS in oncology include significantly reduced intraoperative blood loss, shorter hospital stays, and accelerated postoperative recovery, allowing for earlier initiation of adjuvant chemotherapy or radiotherapy. In Endometrial Cancer, MIS is now the preferred approach due to its superior morbidity profile without compromising survival. However, in Cervical Cancer, the role of MIS remains a subject of intense debate following the LACC trial results, leading to a more cautious, patient-centric selection process. The review also explores the integration of Sentinel Lymph Node (SLN) mapping using indocyanine green (ICG) fluorescence, which has enhanced nodal staging accuracy while minimizing the risk of lymphedema.

Conclusion: MIS has firmly established its role in modern gynecological oncology, offering a balance between oncological radicality and quality of life. While challenges remain in standardizing MIS for specific high-risk malignancies, ongoing technological refinements in robotic platforms and preoperative imaging continue to expand the boundaries of what is surgically possible.

Keywords: Minimally Invasive Surgery (MIS), Gynecological Oncology, Laparoscopy, Robotic-Assisted Surgery, Endometrial Cancer, Sentinel Lymph Node, LACC Trial.