Endometrial cancer is a type of cancer that develops in the lining of the uterus. It is the most common type of uterine cancer and is usually detected in its early stages.

However, treatment can be challenging, especially for patients with advanced or recurrent disease. Surgery is often the preferred treatment option for endometrial cancer, and new surgical techniques are constantly being developed to improve outcomes. This article discusses some of the latest surgical options for endometrial cancer patients.

1. Laparoscopic Surgery

Laparoscopic surgery is a minimally invasive surgical technique that uses small incisions and specialized surgical tools to remove the uterus and other affected tissue in endometrial cancer patients.

This technique has several advantages over traditional open surgery, including smaller incisions, shorter hospital stay, less pain and scarring, and quicker recovery time. Laparoscopic surgery is also associated with a lower risk of complications and improved quality of life for patients.

2. Robotic Surgery

Robotic surgery is a newer type of minimally invasive surgery that uses a robotic system to perform surgical procedures. It allows the surgeon to operate with greater precision and control, and provides enhanced visualization of the operative field.

In robotic surgery for endometrial cancer, the robotic system is used to remove the uterus and other affected tissue. This technique has been shown to reduce blood loss, shorten hospital stay, and result in less pain and scarring compared to open surgery.

3. Sentinel Lymph Node Mapping

Sentinel lymph node mapping is a technique that involves injecting a dye or radioactive substance into the uterus to identify the lymph nodes that are most likely to contain cancer cells.

This allows the surgeon to remove only the affected lymph nodes, rather than removing all of the lymph nodes in the pelvis. Sentinel lymph node mapping has been shown to decrease the risk of lymphedema, a condition in which excess fluid accumulates in the tissues and causes swelling and discomfort.

4. Fertility-Sparing Surgery

Endometrial cancer is typically treated with a hysterectomy, which involves removing the uterus and sometimes the ovaries and fallopian tubes. For younger women who still want to have children, fertility-sparing surgery may be an option.

This involves removing only the affected tissue, rather than the entire uterus. Fertility-sparing surgery is usually followed by close monitoring and hormonal therapy to help prevent cancer recurrence.

5. Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

HIPEC is a treatment that involves applying heat and chemotherapy directly to the abdominal cavity after surgery. It is used in patients with advanced or recurrent endometrial cancer to help destroy any remaining cancer cells and improve outcomes.

HIPEC has been shown to improve progression-free survival and overall survival in patients with advanced endometrial cancer.

6. Nerve-Sparing Surgery

Nerve-sparing surgery is a technique that aims to preserve the nerves that control bladder and bowel function during endometrial cancer surgery. This can help to reduce the risk of incontinence and other urinary or bowel problems after surgery.

Nerve-sparing surgery may be especially beneficial for patients who have already undergone radiation therapy in the pelvic area.

7. Hysterectomy with Morcellation

Morcellation is a technique that is sometimes used during hysterectomy to remove the uterus in smaller pieces, rather than removing it whole. However, there have been concerns about the risk of spreading undetected cancer cells during morcellation.

Some surgical centers have stopped using morcellation altogether, while others have implemented strict guidelines to minimize the risk of cancer spread.

8. Enhanced Recovery After Surgery (ERAS)

ERAS is a multidisciplinary approach to perioperative care that aims to optimize patient outcomes and reduce complications after surgery.

It involves a range of interventions, such as preoperative education, early mobilization, and multimodal pain management. ERAS protocols have been shown to improve patient satisfaction, reduce hospital stay, and lead to better overall outcomes after endometrial cancer surgery.

9. Single-Incision Laparoscopic Surgery (SILS)

SILS is a type of laparoscopic surgery that uses a single incision, usually in the belly button, to remove the uterus and other affected tissue.

This technique can result in even smaller scars and less pain and discomfort for patients compared to traditional laparoscopic surgery. However, SILS is a technically challenging procedure that may not be suitable for all patients.

10. Combined Surgery and Radiation Therapy

For patients with advanced endometrial cancer, a combination of surgery and radiation therapy may be recommended.

This involves removing the uterus and other affected tissue, followed by radiation therapy to the pelvis to help destroy any remaining cancer cells. Combined surgery and radiation therapy has been shown to improve survival in some patients with advanced or recurrent endometrial cancer.