Surgical Innovations: Sentinel Mapping and Robotics
Surgery is the cornerstone of endometrial cancer management, typically involving a Total Laparoscopic Hysterectomy (TLH) and Bilateral Salpingo-Oophorectomy (BSO). However, the management of lymph nodes has undergone a paradigm shift.
Historically, surgeons performed a "full pelvic lymphadenectomy," which often resulted in lymphedema (chronic, painful leg swelling).
Today, the standard of care has shifted to Sentinel Lymph Node (SLN) Mapping. Using a fluorescent dye called Indocyanine Green (ICG) and infrared robotic cameras, surgeons can identify the "sentinel" node—the first node the cancer would theoretically spread to. If this node is negative for cancer, the remaining nodes can be left intact. This technique provides the same diagnostic accuracy as a full dissection but with significantly lower morbidity. In cases where the tumor is high-grade, the surgery may also include an omentectomy (removal of the fatty lining of the abdomen) to check for microscopic peritoneal spread.