Surgery in Gynecologic Oncology -
Yesterday, Today and Tomorrow

Many people say that nothing new occurs in surgery - we just keep recycling old surgical procedures and think we have discovered something new. I hope in this dissertation to convincingly disprove that myth.

It has been 37 years since I graduated from medical school. All of the topics that I will discuss involve changes that I have personally seen come about over those years, involving the surgery of gynecologic cancer, and there are many other developments that I will not have time to mention. I will, of necessity, have to deal with each advancement in a very superficial fashion. I will not be able to amplify my statements by reviewing the literature in detail. I will first deal with “ Advances in Diagnosis” and how this has influenced our surgical approach to gynecologic cancer. I will discuss the various “ Changes in surgical treatment” that have occurred and the development of “Endoscopic Surgical Techniques”. I will mention briefly the role of “Prophylactic Surgery”, the profound changes that have occurred in the “Perioperative Management” of our patients, the revolution that will occur in the future with the increasing use of “Molecular Biology ”, the role “Computer Simulation/Virtual Reality” will have in the future of surgery, and lastly, I will discuss the developing “Competency Movement” which will profoundly affect the nature of our medical education and clinical practice in the future.

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