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Role of Minimally Invasive Surgery in Gynecologic Oncology: An Updated Survey of Members of the Society of Gynecologic Oncology
  1. Lesley B. Conrad, MD*,
  2. Pedro T. Ramirez, MD,
  3. William Burke, MD,
  4. R. Wendel Naumann, MD§,
  5. Kari L. Ring, MD, MS,
  6. Mark F. Munsell, MS and
  7. Michael Frumovitz, MD, MPH
  1. *Department of Gynecologic Oncology, The University of Texas Southwestern Medical Center, Dallas, TX;
  2. Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX;
  3. Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY; and
  4. §Department of Gynecologic Oncology, Levine Cancer Institute, Charlotte, NC;
  5. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX.
  1. Address correspondence and reprint requests to Michael Frumovitz, Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, PO Box 301439, Unit 1362, Houston, TX 77230-1439. E-mail: mfrumovitz{at}mdanderson.org.

Abstract

Objectives To evaluate the current patterns of use of minimally invasive surgical procedures, including traditional, robotic-assisted, and single-port laparoscopy, by Society of Gynecologic Oncology (SGO) members and to compare the results to those of our 2004 and 2007 surveys.

Methods The Society of Gynecologic Oncology members were surveyed through an online or mailed-paper survey. Data were analyzed and compared with results of our prior surveys.

Results Four hundred six (32%) of 1279 SGO members responded. Eighty-three percent of respondents (n = 337) performed traditional laparoscopic surgery (compared with 84% in 2004 and 91% in 2007). Ninety-seven percent of respondents performed robotic surgery (compared with 27% in 2007). When respondents were asked to indicate procedures that they performed with the robot but not with traditional laparoscopy, 75% indicated radical hysterectomy and pelvic lymphadenectomy for cervical cancer. Overall, 70% of respondents indicated that hysterectomy and staging for uterine cancer was the procedure they most commonly performed with a minimally invasive approach. Only 17% of respondents who performed minimally invasive surgery performed single-port laparoscopy, and only 5% of respondents indicated that single-port laparoscopy has an important or very important role in the field.

Conclusions Since our prior surveys, we found a significant increase in the overall use and indications for robotic surgery. Radical hysterectomy or trachelectomy and pelvic lymphadenectomy for cervical cancer and total hysterectomy and staging for endometrial cancer were procedures found to be significantly more appropriate for the robotic platform in comparison to traditional laparoscopy. The indications for laparoscopy have expanded beyond endometrial cancer staging to include surgical management of early-stage cervical and ovarian cancers, but the use of single-port laparoscopy remains limited.

  • Minimally invasive surgery
  • Gynecologic oncology
  • Robotic surgery
  • LESS
  • Ovarian cancer
  • Uterine cancer
  • Cervical cancer

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Footnotes

  • This research was supported in part by the National Institutes of Health through MD Anderson’s Cancer Center Support Grant CA016672.

  • The authors declare no conflicts of interest.

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