Interpretation
Globally, a lot of minimally invasive surgeons still prefer the transperitoneal approach since the anatomical landmarks are similar to laparotomy, and there’s more experience in performing other gynaecological procedures using this approach.
The treatment of endometrial cancer is still heterogeneous around the world, and outcomes vary greatly. The incidence of endometrial cancer is escalating due to the global obesity epidemic. Thus, surgical morbidity will thrive. Surgeons should focus on both oncologic results (e.g. survival) and surgical morbidity.
Personalised medicine is becoming the standard of care, so we need the necessary tools in gynaecologic oncology to offer each woman with endometrial cancer the best treatment option. Applying the same surgery to all patients is obsolescent; each individual is different, with different types of obesity, and different risks. We believe umbilical SAD could be included in the preoperative assessment of endometrial cancer patients undergoing minimally invasive para-aortic lymphadenectomy. It could help surgeons and patients choose the safest option, and decide whether or not the transperitoneal approach is suitable.