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 UNUSUAL CASE
Year : 2009  |  Volume : 5  |  Issue : 4  |  Page : 111-114

Laparoscopic salvage total pelvic exenteration: Is it possible post-chemo-radiotherapy?


1 Section of Laparoscopic Urology, Institute of Urology, University College Hospital, London, United Kingdom
2 Section of Laparoscopy and Robotic Surgery, University of Rochester Medical Center, Rochester, NY, USA
3 Section of Minimally Invasive Surgery, Gujarat Cancer and Research Institute, Ahmadabad, India

Correspondence Address:
H Patel
Section of Laparoscopic Urology Surgery, University College Hospital, London
United Kingdom
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-9941.59310

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Indications for total pelvic exenteration in a male (removal of the bladder, prostate and rectum) and in a woman (removal bladder, uterus, vagina, ovaries and rectum) are rare. The advanced stage generally dictates that the patient has some form of chemotherapy or radiotherapy, or a combination of two to shrink/debulk the tumour. We report the first two cases of a salvage laparoscopic total pelvic exenteration in a male for rectal adenocarcinoma invading into the bladder and prostate, post-chemo-radiotherapy and in a woman for squamous cell carcinoma of cervix invading the bladder and rectum post-chemo-radiotherapy. Salvage surgery is often difficult and has been noted to have high morbidity. Applying a laparoscopic approach to this group may have advantages for the patient and the surgeon, i.e. less pain, early recovery and magnified views. As we have technically shown it to be possible, perhaps laparoscopic approaches should be discussed if the teams in these centres are of advanced laparoscopic surgeons working in multi-skilled groups.






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