Changing Backgrounds and Groundbreaking Changes: Gynecological surgery in the third decade of the 21st century

In the third decade of the 21st century, gynecological surgeons are faced with new technical developments but also with new expectations. The last decades have emphasized the role of individualized approaches to patients and treatments, an increasing role of the molecular diagnostics for previously genuine “surgical” decisions, as well as better awareness of the role of the surgeon ("human factor") for both - surgical successes and mishaps. These trends take place either as a reaction to the pitfalls of the modern surgery, e.g. not satisfying reduction of complication rates or the uncertainty about the oncological risks and long-term outcomes of minimally invasive approaches (e.g. following the LACC trial or the morcellation debate) and, independently, as a result of better understanding of surgeries and surgeons, e.g. due to increasing reflection about the role of education, training or non-surgical skills.

We invite submissions dealing with “changing backgrounds” and “groundbreaking changes” of the gynecologic surgery . We encourage the authors to submit original papers, review articles and case reports covering all aspects of gynecological surgery, including interdisciplinary themes relevant to gynecology.

The “changing backgrounds” are represented by (but not limited to) e.g.:
- trends towards re-discovering and re-definition of surgical anatomy,
- importance of predictable and verifiable surgical competence – role of national and international certifications,
- new concepts of surgical education, by using virtual reality, surgical games and simulators,
- increasing awareness of surgeon-related complications (roles of “human error”, non-technical skills, fatigue, duty hours etc.),
- impact of the surgery on the surgeon (surgical profession from the perspective of occupational medicine).

The “groundbreaking changes” are represented by (but not limited to) e.g.:
- differentiated surgical-oncological strategies in accordance with molecular tumor characteristics (e.g., new perspectives on surgical treatment of endometrial cancer according to molecular subtypes),
- evolving role of the molecular biology in the treatment of rare gynecological tumors
- increasing role of the robotic-assisted surgery including newest developments within robotics,
- increasing surgical and oncological safety of the sentinel concept due to new (e.g. indocyanine green based) techniques,
- controversies about and improvements of the tissue morcellation techniques,
- re-definition and self-limitation of cervical cancer surgery after the LACC trial,
- shift from vaginal to laparoscopic concepts in urogynecology,
- self-limiting (less radical) trends within endometriosis surgery,
- most recent developments in biomarker research.

We would like to acknowledge Prof. Stoyan Kostov who has acted as coordinator and has contributed to the preparation of the proposal for this Research Topic.