The Role of Laparoscopy in the Management of Gynecologic Malignancy; Camran Nezhat, MD, Farr Nezhat, MD, Ceana H. Nezhat, MD, Matthew O. Burrell, MD, Benedict B. Benigno, MD & Carlos Ramirez, MD; Seminars in Surgical Oncology 10:431-439 (1994)

With the advent of minimally invasive laparoscopic techniques, most gynecologic procedures for benign conditions can be performed in an outpatient setting. However, the role of such techniques in gynecologic oncology is not well defined. By reviewing the literature and presenting some new data, we attempt to elucidate the applications of operative videolaparoscopy in gynecologic oncology. Advanced laparoscopic techniques are utilized for the management of cervical cancer as well as the staging and treatment of endometrial and ovarian cancers. Such techniques are used in performing radical hysterectomy for early stage cervical cancer, pelvic and paraaortic lymphadenectomy, and second look laparoscopy following chemotherapy for ovarian cancer. Even though preliminary data are encouraging, large prospective controlled studies with long-term follow-up are necessary to better define the role and limitations of laparoscopy in the treatment of gynecologic malignancies.

Laparoscopic Radical Hysterectomy with Paraaortic and Pelvic Node Dissection, Camran R. Nezhat, MD, Matthey O. Burrell, MD, Farr R. Nezhat, MD, Benedict B. Benigno, MD, & Charles E. Welander, MD; Am J Obstet Gynecol, 1992;166:864-5

We report the first case of a laparoscopic radical hysterectomy an paraaortic and pelvic lymphadenectomy to treat a stage IA2 carcinoma of the cervix. To our knowledge, a laparoscopic radical hysterectomy with laparoscopic paraaortic lymphadenectomy has not been previously described.

Laparoscopic Radical Hysterectomy and Laparoscopically Assisted Vaginal Radical Hysterectomy with Pelvic and Paraaortic Node Dissection, Camran R. NEzhat, MD, Farr R. Nezhat, MD, Matthew O. Burrell, MD, Carlos E. Ramirez, MD, Charles Welander, MD, Jesus Carrodeguas, MD, & Ceana H. Nezhat, MD; J Gynecol Surg, 9:105, 1993

Nineteen women underwent laparoscopic radical hysterectomy or laparoscopically assisted vaginal radical hysterectomy, with pelvic node dissection and paraaortic node dissection when indicated. One procedure was converted to laparotomy due to equipment failure (at The University of Puerto Rico). There were two minor postoperative complications. The first, febrile morbidity resulting from a urinary tract infection, responded to medical therapy. The second was incisional bleeding, which was controlled with sutures applied using a local anesthetic. No major postoperative complications were noted, there have been no incidents of recurrence, and the follow-up results are encouraging.

Laparoscopic Surgery for Gynecologic Cancer, Camran Nezhat, MD, Daniel S. Seidman, MD, Farr Nezhat, MD, Ceana H. Nezhat, MD; Surgical Technology International IV

No abstract available.

Four Ovarian Cancers Diagnosed During Laparoscopic Management of 1011 Women with Adnexal Masses, Farr Nezhat, MD, Camran Nezhat, MD, Charles E. Welander, MD, & Benedict Benigno, MD; Am J Obstet Gynecol, 1992;167:790-6

The study was conducted to assess the value of laparoscopic management of adnexa masses. Two concerns we wish to address are the failure to diagnose early ovarian cancer at laparoscopy and worsening the prognosis of stage I cancer by spilling fluid during surgery. All operations were performed in the outpatient surgical suite of a large suburban hospital. After extensive patient screenings, which included history and physical examination, preoperative serum CA-125 levels (since 1988), and pelvic ultrasonography, 1209 adnexal masses were managed laparoscopically. Of 1011 patients with surgical management, ovarian cancer was discovered intraoperatively in four. Our findings indicate that with consistent use of frozen sections of all cyst walls and suspicious tissue, laparoscopic management did not alter the prognosis. Neither CA-125 level, pelvic ultrasonography, nor peritoneal cytologic testing had sufficient diagnostic specificity to predict malignancy. Experienced surgeons using intraoperative histologic sampling may safely evaluate adnexal mass laparoscopically.

Laparoscopic Excision of Ovarian Neoplasms Subsequently Found to be Malignant; Camran Nezhat, MD, Farr Nezhat, MD, Sheryl L. Stilfen, MD, Benedict Benigno, MD, Matthew Burrell, MD, Charles Welander, MD; Obstet Gynecol Vol 78, No. 2, Aug/1991

Letter to the editor in reference to article: "Laparoscopic excision of ovarian neoplasms subsequently found to be malignant", (Obstet Gynecol 1991:77:563-5), Maiman et al surveyed gynecologic oncologists to assess the quality of care and effect on the outcome of ovarian masses initially managed laparoscopically. We would like to suggest that the quality of laparoscopic care in the survey needs to be examined more carefully...

Laparoscopic Radical Hysterectomy with Paraaortic and Pelvic Node Dissection; Camran R. NEzhat, MD, Matthew O. Burrell, MD, Farr R. Nezhat, MD, Benedict B. Benigno, MD, Charles E. Welander, MD; Am J of Ob/Gyn, Vol. 166, No.3, pp. 864-65, 3/1992.

We report the first case of a laparoscopic radical hysterectomy and paraaortic and pelvic lymphadenectomy to treat a stage IA2 carcinoma of the cervix. To our knowledge, a laparoscopic radical hysterectomy with laparoscopic paraaortic lymphadenectomy has note been previously described.