Introduction/Background Lateral pelvic sidewall involvement by gynecological tumors occurs in 8.3% of patients with cervical cancer after pelvic radiaton. Laterally extended endopelvic resection (LEER), based on the ontogenetic compartment theory, provides a potential surgical option for patients for whom palliative therapy is the only alternative. This complex and ultraradical surgical technique allows a high rate of complete resection in more than 70% of patients with gynecological cancers

Methodology Clinical case: We present a a 34-year-old patient was diagnosed with locally advanced cervical cancer treated with chemoradiotherapy and brachytherapy. Lateral pelvis side wall recurrence occurred three years later.

After the discussion at the multidisciplinary tumor board, it was decided LEER resection as the only curative option.

Results Video explain: At first, we dissected the innominate space to see perfectly and with safety the external iliac vessels, obturator Nerve and Lumbosacral Trunk.

Second step is the dissection of the ureter to his complete mobilization. We continue with the dissection internal iliac artery and its terminal branches.

When the dissection is finish, we can see all the structures as in the video. Then, we have to ligate with suture or hemoclip both internal iliac artery and its branches.

Next, we dissected the hypogastric nerve and ligate internal iliac vein.

We continue the resection of obturator nerve, vessels and muscle, reaching up to the greater sciatic foramen. At this point, nine step is the dissection of lumbosacral plexus.

To remove the surgical piece, it is necessary to ligate the ureter, later we introduce a double J catheter to reimplant the ureter.

Finally, we achieved the limit of the dissection in the elevator ani muscle, and dissected the tendinous arch, endopelvic fascia and elevator ani muscle, reaching the ischiorectal fossa . We resect the parametrium and extract the piece.

Conclusion LEER is a curative option to consider in sidewall tumor recurrences