The Journal of Minimally Invasive Gynecology
Volume 17, Issue 3 , Pages 379-382, May 2010

Laparoscopically Assisted Vulvocolpohysterectomy and Abdominoperineal Resection with Sigmoid Vaginal Replacement

  • Angel Martin Jimenez, MD

      Affiliations

    • Corresponding Author InformationCorresponding author: Angel Martin Jimenez, MD, Hospital Son Llatzer, Gynecology, c/ manacor Km4, Palma Mallorca, 07198, Spain.

Department of Gynecology, Hospital Son Llatzer, Palma Mallorca, Spain

Received 18 November 2009; accepted 19 February 2010.

Abstract 

Background

In this report, we discuss the feasibility of laparoscopy for the resection of recurrent invasive vulvar cancer involving the vagina and anus (stage IVA), requiring radical surgical treatment.

Methods

Successive steps of surgery are discussed: laparoscopic mobilization of the uterus, colon, and rectum for a posterior compartment exenteration (radical vulvectomy, colpohysterectomy, and abdominoperineal resection) and primary neovaginal reconstruction with sigmoid vaginal replacement.

Results

Duration of surgery was 240 minutes. There was no postoperative complication except for a small dehiscence of the perineal wound that healed completely without intervention. The patient was discharged 10 days after surgery. One month after surgery, coloplasty showed a good perineal opening and a depth of 12 cm. Minimal prolapse of the mucous of the coloplasty and abundant secretion could be observed. Adjuvant radiotherapy was indicated.

Conclusions

This combination of laparoscopic techniques is a potential alternative for exenteration or abdominoperineal resection requiring vaginal reconstruction.

Keywords: Vulvar cancer, Abdominoperineal resection, Laparoscopy, Neovagina

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 The author has no commerical, proprietary or financial interest in the products or compaines described in this article.

PII: S1553-4650(10)00082-8

doi:10.1016/j.jmig.2010.02.006

The Journal of Minimally Invasive Gynecology
Volume 17, Issue 3 , Pages 379-382, May 2010

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