Minimally invasive surgery (MIS) has many benefits, in the form of reduced postoperative morbidity, improved recovery and reduced inpatient stay. It is imperative, however, when new techniques are adopted, in the context of treating oncology patients, that the oncological efficacy and safety are established rigorously rather than assumed based on first principles. Here we have attempted to provide a comprehensive review of all the contentious and topical themes surrounding the use of MIS in the treatment of endometrial and cervix cancer following a thorough review of the literature. On the topic of endometrial cancer, we cover the role of laparoscopy in both early and advanced disease, together with the role and unique benefits of robotic surgery. The surgical challenge of patients with a raised body mass index and the frail and elderly are discussed and finally the role of sentinel lymph node assessment. For cervical cancer, the role of MIS for staging and primary treatment is covered, together with the interesting and highly specialist topics of fertility-sparing treatment, ovarian transposition and the live birth rate associated with this. We end with a discussion on the evidence surrounding the role of adjuvant hysterectomy following radical chemoradiation and pelvic exenteration for recurrent cervical cancer. MIS is the standard of care for endometrial cancer. The future of MIS for cervix cancer, however, remains uncertain. Current recommendations, based on the available evidence, are that the open approach should be considered the gold standard for the surgical management of early cervical cancer and that MIS should only be adopted in the context of research. Careful counselling of patients on the current evidence, discussing in detail the risks and benefits to enable them to make an informed choice, remains paramount.

微创手术 (MIS) 有许多好处，包括减少术后发病率、改善恢复和减少住院时间。然而，当在治疗肿瘤患者的背景下采用新技术时，必须严格确定肿瘤学的疗效和安全性，而不是基于第一原则假设。在这里，我们试图在全面回顾文献后，对围绕使用 MIS 治疗子宫内膜癌和宫颈癌的所有有争议的主题进行全面回顾。关于子宫内膜癌，我们涵盖了腹腔镜检查在早期和晚期疾病中的作用，以及机器人手术的作用和独特优势。讨论了体重指数升高的患者以及体弱和老年人的手术挑战，最后讨论了前哨淋巴结评估的作用。对于宫颈癌，涵盖了 MIS 在分期和主要治疗中的作用，以及与此相关的有趣且高度专业化的保留生育治疗、卵巢移位和活产率主题。我们最后讨论了围绕根治性放化疗和盆腔切除术治疗复发性宫颈癌后辅助子宫切除术的作用的证据。MIS 是子宫内膜癌的护理标准。然而，宫颈癌 MIS 的未来仍然不确定。目前的建议，基于现有证据，是开放式方法应被视为早期宫颈癌手术治疗的金标准，而 MIS 应仅在研究背景下采用。根据当前证据对患者进行仔细咨询，详细讨论风险和益处，使他们能够做出明智的选择，仍然是最重要的。