1192 Total pelvic exenteration with radical vulvectomy and anorectal amputation in 10 steps

Introduction/Background We performed a total pelvic exenteration with radical vulvectomy and anorectal amputation for Invasive loco regional relapse with urethral, vaginal and anal involvement of a invasive vulvar squamous cell carcinoma. Methodology We recorded a complete surgical procedure and decided to separate the operative steps in abdominal and perineal time. Then concerning the abdomen we devided in anatomical regions : anterior, posterior and lateral. Results Abdominal resection: Step 1. Paravesical and pararectal spaces dissection Step 2. Ureterolysis and ureteral section Step 3. Retzius dissection and ligation of Santorini's plexus Step 4. Parametrial section Step 5. Pre sacral and retro rectal space development Step 6. Rectal section Step 7. Endopelvic fascia openning Perineal resection Step 8 Surgical margins Step 9 Operative specimen closure Step 10 Levator ani muscles section Conclusion We have produce a surgical training video on the complex procedure of pelvic exenteration with total vulvectomy and anorectal amputation in 10 steps. Disclosures -