Each year endometrial cancer is diagnosed in approximately 11.700 women in Germany. Operation is the therapy of choice in the primary treatment of patients with endometrial cancer. The traditional abdominal approach, vaginal, laparoscopic and robotic-assisted methods are available for the surgical treatment of EC today. This article compares and evaluates these different treatment options. With rising incidence of obesity, number of patients with endometrial cancer will also increase. However, operations in obese patients are more challenging. Laparotomy as standard therapy in endometrial cancer patients stage I and II should be replaced by laparoscopic approaches. Laparoscopy is oncologically adequate to open procedures and offers many advantages to patients. Robotic surgery in the treatment of endometrial cancer is still under evaluation. Most controversial points of treatment today are indication and extention of lymphadenectomy in different stages. In advanced tumor stages, optimal debulking should be performed in order to improve effectiveness of adjuvant chemotherapeutic and/or radiation therapy.
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