Principles of Gynecologic Oncology Surgery

I. Introduction

II. Principles of abdominal and pelvic surgery

III. Abdominal and Pelvic Anatomy

IV. Vulvar/Vaginal Cancer

1. Preoperative evaluation

2. Vulvectomy and sentinel node mapping

3. Groin lymphadenectomy

4. Vaginectomy

5. Management of surgical complications

V. Cervical Cancer

1. Preoperative evaluation

2. Indications for surgery for early- and locally advanced disease

3. Conservative surgery

4. Radical hysterectomy

5. Sentinel node mapping

6. Surgical staging for treatment planning

7.  Management of surgical complications

VI. Endometrial Cancer

1. Preoperative evaluation

2. Indications for sentinel node mapping and lymphadenectomy

3. Technique of standard hysterectomy and lymphadenectomy

VII. Ovarian Cancer

1. Preoperative evaluation

2. Indications for laparoscopic assessment for cytoreduction

3. Radical upper abdominal surgery (liver, diaphragm, spleen)

4. Radical pelvic surgery

5. Complications and management of radical cytoreduction

VIII. Pelvic Exenteration

1. Preoperative evaluation

2. Removal of specimen (would refer to other chapters for bowel surgery, creation of urinary conduit, and reconstruction)

3. Complications of exenteration   

IX. Surgery on the Intestinal Tract

1. Principles (vascularity, tension free, hand sewn vs stapled, etc)

2. Small bowel resection/anastomosis

3. Large bowel resection/anastomosis

4. Creation of a stomae

5. Complications and management of complications

X. Surgery on the Urinary Tract

1. Principles

2. Repair of cystotomy

3. Reimplantation of ureter

4. Creation of neobladders (incontinent pouches, continent pouches, etc)

5. Complications and management

XI. Pelvic Reconstructive Procedures

1. Rectus abdominus flap

2. Gracilis flap

3. Continent and incontinent urinary diversion

XII. Management of General Complications

1. GI injuries

2. GU injuries

3. Vascular injuries

XIII. Management of Radiation Complications

1. Radiation-related bowel obstruction

2. Fistulae

3. Radiation necrosis

XIV. Novel Surgery in Gynecologic Oncology

1. Image-guided surgery

2. Single-site minimally invasive surgery

3. Robotic surgery