Minimally Invasive Staging Surgery for Cancer

Staging laparoscopy (SL) is used to assess for radiographically occult metastatic disease and local resectability in selected patients with gastrointestinal malignancies. SL may avoid nontherapeutic laparotomy in patients with unresectable cancer and is associated with shorter length of hospital stay and time to receipt of systemic therapy compared with nontherapeutic laparotomy. With improvements in preoperative imaging, careful patient selection for SL is imperative. SL and peritoneal washings should be considered for patients with distal gastroesophageal and locally advanced gastric cancer before planned neoadjuvant chemotherapy or resection. SL should be considered in selected high-risk patients with hepatopancreatobiliary malignancies.