Case Series: Diagnosis and Treatment of Four Rare Cancers by a Single Surgeon Due to Systematic Mapping and Near Contact Techniques

No standard criteria exist for how to perform a diagnostic laparoscopy. This case series provides evidence of the importance of standardized, reproducible techniques. A single non-oncologic gynecologic surgeon used Near-Contact Laparoscopy (NCL) and Systematic Mapping of the Abdomen and Pelvis (S-MAP) techniques, resulting in the incidental finding and curative treatment of 4 rare cancers over 3 years. Three were neuroendocrine tumors of the appendix (incidence 0.95/100,000; probability of 3 by one surgeon: 0.0000000001). The fourth was a 2 mm well-differentiated papillary mesothelioma (WDPM). All 4 were cured. 3 of 3 infertile patients subsequently achieved pregnancy. The NCL technique was originally coined by Dr. Redwine (PMID: 3190209). The S-MAP method was described in the NaProTechnology textbook by Dr. Thomas Hilgers, and the S-MAP term coined by this author. Case D used robotic-assisted laser excision. Standardization should be incorporated as the gold standard.