Endometrial Cancer and the Role of Hysteroscopy, Dilemmas and Perspectives

Abstract

Hysteroscopy holds a key role in minimally invasive gynecological surgery, particularly in diagnosing endometrial cancer. Its relevance continues to grow, driven by advancements in technology and improved training of gynecological endoscopists. While modern hysteroscopy is a product of contemporary medicine, its roots trace back to early pioneers like Bozzini, who first attempted uterine cavity visualization. For generations, gynecologists dreamed of directly observing intrauterine pathology—a vision made possible today through hysteroscopy. This technique is now indispensable in both diagnostics and treatment of benign and malignant uterine conditions. Croatia has played a leading role in this field. Since 2000, the Croatian Society for Gynecological Endoscopy has organized postgraduate courses in Zabok, training nearly a thousand endoscopists from Southeast Europe. These courses, named in honor of Prof. Kurt Semm, represent the region’s longest-running and most respected training in minimally invasive gynecological surgery. Notably, the first laparoscopic hysterectomy in Southeast Europe was performed in 1994 at Zabok General Hospital by Prof. Miroslav Kopjar and Dr. Nikša Knezović. Hysteroscopy has since become a routine part of clinical practice, both diagnostically and therapeutically. With its minimal invasiveness and high diagnostic accuracy—enabled by excellent visualization—it allows for targeted sampling and treatment. The future integration of artificial intelligence promises even more precise and personalized approaches. As the healthcare system faces new challenges, hysteroscopy remains a vital tool in improving outcomes in endometrial cancer care through enhanced diagnostics, minimally invasive treatment, and interdisciplinary collaboration.