Advancing gynecologic surgery through precision, innovation, and evolving surgical technique, this session brings together three presentations that highlight progress in minimally invasive and fertility-preserving care. The discussion opens with a retrospective evaluation of intraoperative proctosigmoidoscopy following bowel endometriosis surgery, offering insight into how surgeons are refining safety checks during a technically demanding procedure. From there, the conversation turns to robotic-assisted uterine artery sparing radical trachelectomy, a fertility-preserving approach to early cervical cancer that aims to maintain reproductive potential while achieving oncologic control. The session closes with the R-Veil technique, introduced through a fascia lata first lateral approach, adding a further option to the reconstructive gynecologic surgeon’s toolkit. Gynecologic oncologists, minimally invasive surgery specialists, and fertility preservation teams will find this session especially relevant for understanding how robotic technique continues to expand options for patients who wish to preserve fertility while receiving effective cancer treatment. The moderated discussion adds valuable perspective on patient selection and long-term outcomes, reflecting continued progress across endometriosis management, oncologic gynecology, and reconstructive technique.