Innovation in surgical oncology

Surgical techniques change through a continuous process of innovation. In recent years, there has been an increased use of minimally invasive surgical techniques for the treatment of malignant tumours. These minimally invasive surgical procedures have advantages for the patient, including less pain and complications following the surgery and a faster recovery. In the UMCG, a new minimally invasive surgical technique for the removal of the adrenal glands has been introduced; the ‘posterior retroperitoneoscopic adrenalectomy’, which turned out to be a better option than the conventional adrenal surgery. Patients have less pain after the surgery and there are fewer complications. This new operating technique has been implemented safely in four international centres, with a learning curve of 24 to 42 procedures. In addition, the ‘minimally invasive inguinal lymphadenectomy’ is introduced, in which the inguinal glands are removed through an endoscopic procedure in melanoma patients with lymph node metastases. This procedure proved to be an attractive alternative to the open technique, with less serious complications and without the need for a surgical re-intervention. When starting a new minimally invasive surgical procedure, the implementation process must be well prepared to ensure safety and ultimately improve the outcome of patients. However, innovation should not be the purpose, but only a way to improve the outcome of these oncological patients.