Laparoscopic surgery is associated with reduced levels of postoperative pain, early discharge from hospital and quick return to normal activity. Chemoradiotherapy is considered as the main treatment for advanced cervical cancers such as FIGO stage II and above. The majority of women with endometrial cancer will be cured by a total hysterectomy and bilateral salpingo-oophorectomy. Meta-analysis has reported lower complication rates and similar recurrence and survival after laparoscopic surgery. The role of laparoscopy in advanced stage ovarian cancer is controversial. Several retrospective studies have reported that laparoscopic surgery is safe and offers outcomes equivalent to open surgery. The main indication for a pelvic lymph node dissection is in the management of cervical cancer often combined with radical surgery. New developments such as robotic laparoscopic surgery and the use of small single-site incisions are likely to further expand the number of women suitable for laparoscopic management and reduce morbidity.

Surgery has various applications in the management of cancer. This chapter discusses the roles performed by surgery such as: diagnosis, staging, treatment, reconstruction, and palliation. It reviews the intraoperative complications of laparotomy. A number of studies have proposed chemotherapy before definitive surgery in patients with advanced ovarian carcinoma. A significant number of women with recurrent disease will develop bowel obstruction, and surgery is often the palliation method of choice. Stage IB disease can be treated by surgery or radiotherapy, and the surgical options are radical vaginal hysterectomy and laparoscopic or extraperitoneal lymph node dissection, and radical trachelectomy with laparoscopic or extraperitoneal lymph node dissection. The standard surgical management for endometrial cancer in the UK has been total abdominal hysterectomy and bilateral salpingo-oophorectomy. Biopsy of a vulval lesion is essential for diagnosis before definitive surgery. Conservative surgery should be considered for young patients with early cervical cancer.