Vulvar carcinoma is a relatively rare cancer entity. However, this disease, in contrast to other gynaecological cancers, recently showed an increasing incidence, including young women. Despite showing a poor response on the administration of chemotherapeutics, vulvar carcinomas have excellent response to surgical treatment when detected in early stages. More than other cancer entities and especially in young females, treatment of vulvar cancer effects body image, sexuality, quality of life and sexual activity. Interdisciplinary decision making, a stage-conforming therapy accompanied with low invasiveness (e.g. lymphadenectomy using the sentinel technique) and further treatment regimens (e.g. radiation) are important steps to preserve the sensitivity and function of the vulva and adjacent organs. Surgical treatment procedures for vulvar cancers have changed during recent years towards tissue-sparing oncoplastic and reconstructive surgery. Previously applied radical surgical approaches, such as en-bloc resection, are often associated with high postoperative morbidity, vulvar deformity and sexual dissatisfaction.

Laparoscopic extensive myomectomy, hysterectomy for large myomas, laparoscopic treatment of endometriosis or treatment of cancer of the uterus are advanced laparoscopic gynaecological procedures. Since they can be very challenging, many special pre-, intra- and postoperative aspects need to be considered. This chapter aims to give insights into the different advanced laparoscopic gynaecological procedures. The preoperative arrangement, the intraoperative setting, key operative steps and the postoperative course are described in detail. An overview of common intraoperative complications like ureter injuries, bladder injuries, gastrointestinal injuries, vascular injuries and pneumoperitoneum-linked complications is given. Some typical postoperative complications like wound-healing problems, bleeding and gastrointestinal lesions are described together with possible treatment options.