Amanika Kumar, M.D., a gynecological oncologist at Mayo Clinic in Rochester, Minnesota, explains the indications and goals of pelvic exenteration surgery: anterior exenteration, posterior exenteration and total exenteration.
Dr. Kumar also discusses the process of this complex surgery — in which most or all of the pelvic organs are removed — and the physical and emotional challenges patients face.
Hi, My name is Monica Kumar, and I'm one of the gynecologic oncologist here at Mayo Clinic. Today, I want to talk to you about pelvic exoneration. Pelvic exoneration is a procedure in which we remove most or all of the pelvic organs, and it is a procedure we usually reserve for recurrent valve are and immaterial or a cervical cancer. It is a complex procedure, but one that can be successful in curing recurrence. When a patient is the appropriate candidate, the procedures convey be an anterior exoneration, removing the gynecologic organs and the bladder, in which case we create a your ASTA me. The euro Sodomy is a portion of bowel that acts as a repository to collect urine from the your orders and drains out through the skin into a bag. Patients may need a post cheerier exoneration, removing the gynecologic organs and the rectum. Then patients will need a permanent colostomy, and sometimes a total exoneration is needed where the entirety of pelvic organs were removed and the patient will have to permanent bags, one for urine and one for stool. Exoneration could be entirely intra abdominal and deal on Lee with internal anatomy. But when a cancer involves the vagina or the vulva. We also remove the skin and the structures of the external genitalia, then using a muscular Catania's flap to cover the defect. Or are plastic Surgeons can help us and help create a neo vagina. Obviously, this type of surgery is a challenge for patients, both physically and emotionally. We at Mayo Clinic have developed a process that streamlines this complex patient care, trying to ease the physical, financial and emotional burden on patients. We have a multi disciplinary team that creates a plan. It includes money, different surgical specialties and oncological specialties, but also includes social work, psychology and physical therapy. Hospitalizations after the procedure can range from one week to 2 to 3 weeks, depending on the patient. But I always tell the patient that this kind of surgery can take six months to feel like you fairly recovered from when cure. Is it possible? Many patients are eager to proceed with such a surgery, and we support them through their complicated recovery. Teaming with are supportive care teams here and locally at Mayo Clinic. We hope that with this unique care for a recurrent cancer, we can offer patients and improve survival and an improved quality of life,