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SF023/#590 Vulvectomy- an operative procedure for CA vulva
  1. R Pratima and
  2. R Sekhon
  1. Rajiv Gandhi Cancer Institute and Rearch Center, Gynaecology Oncology, New Delhi, India


Introduction Increasing knowledge and understanding of the disease has allowed surgical procedures for the treatment of carcinoma of the vulva to become more conservative and individualized to each patient. The exact procedure used depends upon the site, size, and histologic features of the tumor.

Description Preoperative preparation — All women require explanation and counseling about the procedure. General anesthesia is administered. The patient is positioned in lithotomy. The skin is prepared and draped. The patient is examined and the skin to be incised is marked with a pen. A urethral catheter is inserted into the bladder Skin incision is begun with scalpel and the dissection is taken through the subcutaneous fat to the deep fascia and pubic ramus until the intended vaginal resection margin is reached with scalpel, scissors and diathermy. The dissection is carried down toward the clitoral attachments by sweeping the specimen off the periosteum of the pubic bones conserving the deep fascia until the clitoral attachments are reached. The suspensory ligament of the clitoris is clamped, divided, and ligated. The urethro-vaginal incision is now made circumferentially, ensuring that the required margin around the tumor is maintained. The tip of a scalpel Kelly forceps is passed through the specimen in the midline to isolate the crura divide and then suture ligated with absorbable sutures. The specimen is detached completely, and hemostasis is secured. The wound closed primarily.

Conclusion Adequate surgical resection with microscopic tumor-free margin should be the key concern.Oncological resection should be equated with functional outcome.

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