1. ROLE OF MIS IN EARLY STAGE OVARIAN CANCER
Assoc.Prof. PERAPONG INTHASORN
Dept of Obstetrrics and Gynaecology
SIRIRAJ HOSPITAL

2. LAPAROSCOPIC STAGING IN EARLY STAGE
Nezhat et al (Am J Obstet Gynecol 2009)
36 patients
Paraaortic node 12, pelvic node 14
Upstage 7 patients
Complication
1 small bowel obstruction
3 lymphocoel

3. LAPAROSCOPIC STAGING IN EARLY STAGE
3 patient recurrence of disease
Mean FU 55 Mo, all alive without disease

4. LAPAROSCOPIC STAGING IN EARLY STAGE
Park HY. ( AJOG 2013)
Review 3 retrospective stydy
Laparoscopy less blood loss
Conversion rate 3%
Mean FU time > 19 Mo , recurrent rate 9.9%

5. LAPAROSCOPIC STAGING IN EARLY STAGE
Cochran
No high quality RCT

6. LAPAROSCOPIC STAGING IN EARLY STAGE
Tumor rupyure is great concern
Laparoscopic bag

7. Second look laproscopy
Clinical trial
Evaluation after complete response

8. Second look laproscopy
Laparoscopy less blood loss, less operative time (Abu Rustum 1996)

9. SIRIRAJ EXPERIENCE Second look laparoscopy 17 caese
Laparoscopy with peritoneal washing with biopsy
Positive cancer 56%
No serious complication

10. SIRIRAJ EXPERIENCE Restaging 7 patients Blood loss 30- 100 cc
Pelvic node nodes
Paraaortic 3-5 nodes
No serious complication