Robotic surgery for the management of gynecologic cancers allows for minimally invasive surgical removal of cancer-bearing organs and tissues using sophisticated surgeon-manipulated, robotic surgical instrumentation. Early on, gynecologic oncologists recognized that minimally invasive surgery was associated with less surgical morbidity and that it shortened postoperative recovery. Now, robotic surgery represents an effective alternative to conventional laparotomy. Since its widespread adoption, minimally invasive surgery has become an option not only for the morbidly obese but for women with gynecologic malignancy where conventional laparotomy has been associated with significant morbidity. As such, this paper considers indications for robotic surgery, reflects on outcomes from initial robotic surgical outcomes data, reviews cost efficacy and implications in surgical training, and discusses new roles for robotic surgery in gynecologic cancer management. 1. Introduction Management of gynecologic cancer often involves surgery followed by radiation, chemotherapy, or a combination of both therapies. It is important for the gynecologic oncologist to consider technical aspects of surgery as it pertains to a patient’s goals for surgical intervention, planned extent of surgical removal of cancer-bearing organs and tissues, a patient’s postoperative speed of recovery, and how these relate to the timing and administration of future anticancer therapies. Techniques of minimally-invasive surgery, initially involving laparoscopy and more recently robot-assisted surgery, have emerged to address these considerations [1–3]. Early on, gynecologic oncologists found that laparoscopic surgery was associated with less surgical morbidity and shortened postoperative recovery. Robotic surgery has expanded the potential cohort of women capable of undergoing minimally-invasive surgery, now cautiously including the morbidly obese, those in poor health, and those having numerous comorbidities [4–7]. Early clinical successes of robotic surgery in the management of gynecologic cancers have prompted gynecologic oncologists to consider this procedure more often. Here, we discuss use of robotic surgery specifically for gynecologic cancer management, focusing on its applications in the management of cervical, endometrial, and ovarian cancers. 2. Technical Aspects of Robotic Surgery in Gynecologic Cancer Management Robotic surgery differs substantially from laparoscopic surgery in important ways. Conventional laparoscopy utilizes a two-dimensional camera with images projected to monitors
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