Less invasive surgery for gynecologic tumors.

The majority of cancers of the female genital tract are managed primarily by surgery in Western communities. Surgical techniques have developed during the 20th century with a tendency toward increasing radicality in order to deal with those cancers with a propensity for locoregional spread. On occasions during the past 100 years, individual surgeons have made efforts to tailor surgical practice to more appropriately deal with the true risks of spread. In recent times this search for more accurate tailoring has moved on apace and has coincided with the burgeoning interest in minimal access surgical techniques. This review is designed to cover the past year's developments in the quest toward less invasive surgery for gynecologic tumors. A major drawback to tailoring of surgical technique with its inevitable reduction in radicality for some patients is the risk of undertreating the cancer. The temptation for the less experienced or less skilled clinician to reduce radicality because such a move more closely matches his or her level of skill will result in poor results, with the risk that the surgical technique being given a bad name rather than the situation being recognized as a decision to use inappropriate therapy.