The procedure of choice is vulvectomy with simple reconstruction or skin flap. Inguinal lymph node dissection is performed in case of affected lymph nodes (this may modify the stage, the prognosis and any further treatment).
Over the last few years, the sentinel node technique has been gaining ground. The aim is to avoid radical inguinal lymph node dissection in case rapid biopsy of the sentinel node is negative.
This is an operation to remove the entire uterus, as well as the fallopian tubes & ovaries, and its quite common, in case of endometrial (uturine) cancer.
The first total laparoscopic radical hysterectomy, with complete lymph node dissection, was performed in Greece in 2004 by Dr. G. Hilaris and his team.
Laparotomy is still considered a reliable and trustworthy procedure for a trained surgeon to perform whenever deemed clinically necessary.