Introduction/Background*The aim of cytoreduction in advanced ovarian cancer is complete removal of gross disease. Retroperitoneal approach is crucial in radical surgery for advanced ovarian cancer. Hudson-Delle Piane is a radical procedure which allows en-bloc removal of uterus, ovaries, pouch of Douglas peritoneum, recto-sigmoid with a retrograde approach in cases where recto-simoid sparing is not an option.

Methodology We present an educational video on how to perform retroperitoneal en bloc posterior pelvic exenteration in advanced ovarian cancer with a step-by-step procedure. The patient was a 52-year-old woman, with body mass index of 21.1 who presented with abdominal pain and distension; the CT-scan showed peritoneal carcinomatosis. The different phases of the Fagotti’s score performed at diagnostic laparoscopy to triage for the operability, are demonstrated. The Vizzielli’s score was used to determine the risk of post-operative complications in case of primary debulking surgery is also presented.

Result(s)*Immediately after the diagnostic laparoscopy a conversion to laparotomy with a cytoreductive surgery was performed. The Hudson-Delle Piane technique is demonstrated in 10 steps. The surgery lasted 360 minutes and the estimated blood loss was 400 ml. No peri-operative complication was recorded. The histology revealed a FIGO stage IIIC high-grade serous ovarian cancer.

Conclusion*The present video demonstrates that retroperitoneal approach to advanced ovarian cancer with high volume pelvic disease, allows en bloc tumor debulking with safe handling of important structures.