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.