Skip to main content

Surgical Principles and Practices in Gynaecological Oncology: Achieving the Best Outcome

  • 224 Accesses


Despite the recent advances in non-surgical anticancer treatment, surgical resection has remained the most important treatment modality in the management of majority of solid cancers. Whilst chemo- and radiotherapy have both been greatly standardised and protocol driven, surgery has remained highly dependent on human factors. It is imperative to prepare both the patient and the surgical team, and optimise the institutional circumstances well before the operation. Before surgery it is very important to make the correct decision, choose the correct patient, ensure the patient is properly counselled, consent is taken and the whole team including the lead surgeon, anaesthetist, assistants, srub nurses are well informed about the patient and the procedure. Intraoperative factors that affect surgical outcome range from theatre environment, noise levels, adequate infrastructure, surgeon skills, ensuring safe surgery with good clearance of margins. When surgery is to go ahead as planned then the key elements for most cancer operations are exploration, decision-making, resection and reconstruction. Post operative care is very important and includes the principles of enhanced recovery and holistic care to facilitate the patient’s recovery for timely adjuvant treatment.


  • Surgical principles
  • Human factors and teamwork
  • Skillset of surgeons 
  • Surgical resection

This is a preview of subscription content, access via your institution.

Buying options

USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-3-030-94110-9_6
  • Chapter length: 9 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
USD   149.00
Price excludes VAT (USA)
  • ISBN: 978-3-030-94110-9
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Hardcover Book
USD   199.99
Price excludes VAT (USA)


  1. Daley J, Khuri SF, Henderson W, et al. Risk adjustment of the postoperative morbidity rate for the comparative assessment of the quality of surgical care: results of the National Veterans Affairs Surgical Risk Study. J Am Coll Surg. 1997;185:328–40.

    CAS  PubMed  Google Scholar 

  2. Schneider S, Armbrust R, Spies C, et al. Prehabilitation programs and ERAS protocols in gynecological oncology: a comprehensive review. Arch Gynecol Obstet. 2020;301(2):315–26.

    CAS  CrossRef  Google Scholar 

  3. Tsimopoulou I, Pasquali S, Howard R, et al. Psychological prehabilitation before cancer surgery: a systematic review. Ann Surg Oncol. 2015;22(13):4117–23.

    CrossRef  Google Scholar 

  4. Carthey J, de Level MR, Wright DJ, et al. Behavioural markers of surgical excellence. Safety Sci. 2003;41(5):409–25.

    CrossRef  Google Scholar 

  5. Sotto KT, Burian BK, Brindle ME. Impact of the WHO surgical safety checklist relative to its design and intended use: a systematic review and meta-meta-analysis. J Am Coll Surg. 2021;S1072-7515(21):02141–4.

    Google Scholar 

  6. McDonald J, Orlick T, Letts M. Mental readiness in surgeons and its links to performance excellence in surgery. J Pediat Orthop. 1995;15:691–7.

    CAS  CrossRef  Google Scholar 

  7. Suh IH, Chien JH, Mukherjee M, et al. The negative effect of distraction on performance of robot-assisted surgical skills in medical students and residents. Int J Med Robot. 2010;6:377–81.

    CrossRef  Google Scholar 

  8. Wheelock A, Suliman A, Wharton R, et al. The impact of operating room distractions on stress, workload, and teamwork. Ann Surg. 2015;261(6):1079–84.

    CrossRef  Google Scholar 

  9. Mentis HM, Chellali A, Manser K, et al. A systematic review of the effect of distraction on surgeon performance: directions for operating room policy and Surgical training. Surg Endosc. 2016;30(5):1713–24.

    Google Scholar 

  10. Mcleod R, Myint-Wilks L, Davies SE, Elhassan HA. The impact of noise in the operating theatre: a review of the evidence. Ann R Coll Surg Engl. 2021;103:83–7.

    CrossRef  Google Scholar 

  11. Nelson G, Bakkum-Gamez J, Kalogera E, et al. Guidelines for perioperative care in gynecologic/oncology: Enhanced Recovery After Surgery (ERAS) Society recommendations-2019 update. Int J Gynecol Cancer. 2019;29(4):651–68.

    CrossRef  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Janos Balega .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Verify currency and authenticity via CrossMark

Cite this chapter

Balega, J., Barton, D. (2022). Surgical Principles and Practices in Gynaecological Oncology: Achieving the Best Outcome. In: Singh, K., Gupta, B. (eds) Gynecological Oncology. Springer, Cham.

Download citation

  • DOI:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-94109-3

  • Online ISBN: 978-3-030-94110-9

  • eBook Packages: MedicineMedicine (R0)