Acknowledgment The authors wish to thank Karen C. Broadbent and George T. Pisimisis for their great assistance on this chapter. Gynecologic malignancies remain a leading cause of cancer death in women. There are approximately 98,000 new cases and 30,000 deaths…
Pelvic exenteration, the most radical of pelvic procedures, is used with curative or palliative intent in the treatment of women with primary and recurrent pelvic malignancies. In women undergoing total or anterior exenterative procedures, the choice of urinary diversion can…
We restore, repair and make whole those parts … Which nature has given but which fortune has taken away . Gaspar Tagliacozzi (1545–1599) The goals of pelvic and perineal reconstruction in gynecologic oncology surgery may be summarized as follows: Maximize…
A fellowship-trained gynecologic oncologist is expected to be competent in performing gynecologic, gastrointestinal, urologic, and vascular procedures relevant to gynecologic malignancy management. Urologic injury is a known risk factor of pelvic and retroperitoneal surgery in general and in gynecologic surgical…
Bowel manipulation and resection are commonly performed in gynecologic cancer surgery. The principles of bowel surgery are discussed elsewhere in this book (see Chapter 17 ). This chapter focuses on frequent complications surgeons encounter during open and minimally invasive surgery…
The field of gynecologic oncology has undergone an evolution, mirroring the growing knowledge of the pathophysiology of gynecologic malignancies and the introduction of new treatment modalities and innovative techniques. The introduction of targeted therapies, precision medicine, genomic profiling, genetic testing,…
Pelvic exenteration, the en bloc removal of the pelvic organs, is indicated for central recurrent or persistent gynecologic cancer, including cervical, endometrial, vaginal, or vulvar cancer. Even when performed in the setting of specialized centers by highly skilled surgeons, pelvic…
Pelvic exenteration (PE) is a very complex procedure, even currently. In addition to unique surgical erudition and interdisciplinary surgical team involvement, these operations require special expertise for the right candidate selection, postoperative care, and handling of complications. Because of the…
Radical cytoreduction consists of complex surgical procedures that may include extended peritonectomy, diaphragmatic resections, lymphadenectomy, and multiple visceral resections. As a result, it may be difficult to determine which of these innumerable procedures contributes to a specific complication. Patients undergoing…
Pelvis In early stages, removal of the adnexa involved by tumor, a total abdominal hysterectomy with bilateral salpingo-oophorectomy, pelvic and paraaortic lymphadenectomy, and omentectomy are required as part of the surgical staging. Conservative procedures including unilateral salpingo-oophorectomy may be an…