Introduction/Background The laparoscopy has been found to be attractive and safe technique in gynaecological oncology. However, some recent retrospective and prospective reports on early-stage cervical cancer have shown unexpected contrary results in terms of overall and disease-free survival. In our opinion, published discussions to date do not fully address the subject and that it is worth considering important issues that were not given enough attention before.

Methodology We conducted a systematic analysis of current knowledge about laparoscopy in early-stage cervical cancer by reviewing the relevant literature from the fields of basic and clinical research, starting with the results of the Laparoscopic Approach to Cervical Cancer (LACC) study, and including analysis of its appendix and protocol.

Results The preferred surgical access in cervical cancer cases was the subject of a single prospective randomized clinical trial. Other, similarly designed studies on other pelvic tumours are sparse. The biology of cancer, cancer epidemiology, as well as surgical skills and details of laparoscopic techniques underlie the observed differences in survival rates.

Conclusion There are some possibilities (such as limiting the manipulation of the uterus, closure of tubes and ligation of the parametria before using the manipulator, closure of the vaginal cuff, applying warmed and humidified CO2, and limiting intra-abdominal gas pressure) that, if considered and applied, may affect oncological results in selecting laparoscopy as the operative method for early-stage cervical cancer.

Disclosure Nothing to disclose.