Introduction/Background We performed a total pelvic exenteration with radical vulvectomy and anorectal amputation for Invasive loco regional relapse with urethral, vaginal and anal involvement of a invasive vulvar squamous cell carcinoma.

Methodology We recorded a complete surgical procedure and decided to separate the operative steps in abdominal and perineal time.

Then concerning the abdomen we devided in anatomical regions : anterior, posterior and lateral.

Results Abdominal resection: Step 1. Paravesical and pararectal spaces dissection

Step 2. Ureterolysis and ureteral section

Step 3. Retzius dissection and ligation of Santorini’s plexus

Step 4. Parametrial section

Step 5. Pre sacral and retro rectal space development

Step 6. Rectal section

Step 7. Endopelvic fascia openning

Perineal resection

Step 8 Surgical margins

Step 9 Operative specimen closure

Step 10 Levator ani muscles section

Conclusion We have produce a surgical training video on the complex procedure of pelvic exenteration with total vulvectomy and anorectal amputation in 10 steps.

Disclosures -