Entirely Robotic Total Pelvic Exenteration

Abstract

OBJECTIVE: We present an entirely robotic total pelvic exenteration and extended lymphadenectomy with "barreled ureterocutaneostomy" and end colostomy for recurrent endometrial cancer. In 1948, Brunschwig first described a pelvic exenteration as treatment of advanced recurrent malignancy in the pelvis. Currently it represents the only potentially curative option for patients with recurrent endometrial cancer. METHODS: A 69-year-old female with perineal recurrence invading urethral and vaginal walls, lower rectum and anal sphincter was the perfect candidate for total pelvic exenteration. RESULTS: Total operative time was 250 minutes, with a console time of 175 minutes. The estimated blood loss was 365 mL. CONCLUSIONS: Good oncological results are expected after robotic total pelvic exenteration owing to the accurate, precise dissection and the extension of lymphadenectomy in the narrow space of the deep pelvis similar to robotic prostatectomy and total mesorectal excision.