Laparoscopic hysterectomy and cancer.

Laparoscopic hysterectomy with or without oophorectomy is a procedure which is now gaining popularity in the UK. It has been clearly demonstrated that this technique is superior to abdominal hysterectomy and oophorectomy via laparotomy, and often replaces this procedure. In cases where vaginal hysterectomy is likely to prove difficult or impossible in the hands of most surgeons, the laparoscopic route is of value. In those cases where dense pelvic adhesions or poor vaginal access exist, or where oophorectomy is co-indicated, laparoscopic surgery converts operation via laparotomy to a less invasive procedure, with consequent benefits in terms of both patient care and bed occupancy. In the case of malignant disease, laparoscopic hysterectomy and oophorectomy is a viable alternative to open abdominal hysterectomy, but great care must be taken that patients with malignant disease are not under-treated.