Maximally Invasive Surgery for the Minimally Invasive Gynecologist

Abstract

The discipline of gynecology has grown immensely in the last decades. Recognition of the complexity of gynecologic pathology, the evolving patient population, and advancements in imaging technology have required the gynecologic surgeon to function at an increasingly rigorous technical level. While minimally invasive routes of surgery remain paramount within the specialty to optimize patient outcomes, the ability to offer open surgery continues to be of the utmost relevance to any practicing surgeon. We assert that fundamental surgical principles of anatomical relationships, expert medical knowledge, and preoperative planning comprise the true skill set acquired through surgical training and that these principles apply regardless of the planned approach to any given case. This article discusses these key tenets of pelvic surgery, explores their relevance to laparotomy cases encountered in complex gynecology, and discusses how they may apply to contemporary training and practice.