LAUSR

INTRODUCTION Pelvic exenteration is characterized by its high aggressiveness and potential associated morbidity [1] . In case of advanced pelvic tumours, en bloc resection of the uterus-vagina, bladder, and rectosigmoid may be the only potentially curative or palliative therapy; however, the anatomical relationship of these structures determines the complexity of this procedure. The minimally invasive approach is not an extended and daily practice, but its inherent advantages make it an auspicious alternative to decrease the morbidity and improve the recovery of these patients [2-4] . In this video we present the steps to perform a complete laparoscopic pelvic exenteration [5] . MATERIAL AND METHODS 76-year-old female with personal history of Stage IA endometrial adenocarcinoma operated in 2015 (Hysterectomy + Double adnexectomy + Lymphadenectomy + adjuvant Radiotherapy) and vaginal relapse in 2017. In 2018, a 5 cm mass was detected at the vaginal stump, infiltrating the urethra, anterior rectum and bladder without distant disease. Laparoscopic total pelvic exenteration was performed including pelvic peritonectomy, cystectomy, vaginal stump and abdominoperineal resection. Subsequently, Bricker-type ureteral reconstruction and terminal colostomy were performed. RESULTS Postoperative stay was 10 days with no associated morbidity. Pathological analysis revealed a squamous adenocarcinoma of endometrium with disease free margins. She is free of disease 14 months after surgery. CONCLUSIONS The laparoscopic approach to total pelvic exenteration in referral units that practice multidisciplinary management might be a safe and feasible approach. Larger studies will be necessary to establish its benefits for short and long term follow-up.