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2022-RA-1377-ESGO Robotic anterior pelvic exenteration: safe and feasible?
  1. Andrei Manu,
  2. Catalin Bogdan Coroleuca and
  3. Elvira Bratila
  1. Ob Gyn, Scog Prof Dr Panait Sarbu, Bucharest, Romania


Introduction/Background With nearly 570,000 new cases/year and 310,000 deaths/year, cervical cancer is the second most frequent cancer in women and the third leading cause of cancer-related deaths in females. The transition of pelvic exenteration from a palliative procedure to a potentially curative one in patients with advanced pelvic cancer has been established. With improving surgical technology and increasing surgical experience, exenteration is a logical extension of current robotical practice. So far, there have been various single case reports in literature of robotic anterior exenteration being done for cervical cancer. The prime indication for pelvic exenteration is recurrent cervical cancer after full radiation.

Methodology We present a review in which we included articles concerning the anterior robotic exenteration and the feasibility and outcomes of this procedure. We will also present a case of 61 years old patient that was diagnosed with squamous cell cervical carcinoma FIGO stage IVA with radio chemotherapy treatment and that underwent robotic anterior exenteration.

Results Robotic pelvic oncosurgery is no longer a novelty. We performed a robotic total hysterectomy with bilateral salpingo-oophorectomy with extended parametric resection, bilateral pelvic lymphadenectomy and radical cystectomy with Bricker ileal conduit diversion in our case. The goal of exenterative surgery should always be resection of the tumor with tumor free margins. The procedure is feasible robotically and if combined with intracorporeal urinary diversion, the overall morbidity and hospitalization can be decreased considerably. Since follow-up of our patient is 10 months, it is too early to discuss survival. Nevertheless, the patient is disease free after 10 months. There were no complications in our case.

Conclusion Robot assisted anterior pelvectomy with anterior vaginal wall preservation is a feasible and mini-invasive technique. Our results have demonstrated the feasibility and oncological safety of performing anterior exenteration robotically in advanced pelvic cancer patients with acceptable morbidity.

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