During the past decade, the clinical utility of laparoscopy has grown exponentially. Improvements in video equipment have made it possible for multiple surgeons to operate simultaneously while allowing nursing and anesthesia personnel to follow along with the progression of the procedure. As a result of the introduction of new equipment and the dedicated work of surgical pioneers whose insight led to the application of these tools in various innovative ways, endoscopy has become an integral part of virtually all fields of surgery.

Rapid technologic and surgical advances in conjunction with a desire to contain the total societal costs of health care have collectively pushed the frontiers of laparoscopic surgery beyond what was envisioned by most surgeons just a few years ago.<sup>48 Montz F.J., Schlaerth J.B. Laparoscopic surgery: Does it have a role in the management of gynecologic malignancies? Clin Obstet Gynecol 1995 ;  38 : 426

Cliccare qui per andare alla sezione Riferimenti</sup> The development of smaller automatic staplers and special operative endoscopic devices has been instrumental in the evolution of operative gynecologic laparoscopy from simple tubal ligations to complex oncologic procedures. There has been a steady increase in the number of reports and series in the literature that describe the use of operative endoscopy for patients with gynecologic malignancies. Moreover, in numerous institutions, operative laparoscopic techniques are now being routinely offered to patients with ovarian, cervical, and endometrial cancer.

Despite these advances, the use of laparoscopy for gynecologic malignancies is still in its infancy. Data are just now beginning to accrue regarding operative times, costs, the thoroughness of the minimal-access approach, complications, and long-term survival. Many of the described techniques are currently undergoing critical evaluation in prospective multicenter clinical trials. Until experience grows and the data from these trials accumulate, many crucial questions regarding the safety and efficacy of the laparoscopic approach will remain unanswered. Although operative laparoscopy promises to be an effective tool, its exact role in the management of gynecologic malignancies is yet to be defined.