About Video

This video demonstrates laparoscopic anterior exenteration. This is a 42-years-old patient married for 28 years, present complaints: hematuria and white discharge per vaginum. MRI: cervical lesion of size approx. 4 × 4 cm. Loss of anterior fat planes. Evidence of parametrial involvement. Posterior fat planes maintained. Biopsy: squamous cell carcinoma. Preoperative diagnosis: Carcinoma cervix, received chemotherapy, radiotherapy, presented with recurrent lesion, planned for laparoscopic anterior exenteration. Port placement: patient placed in modified Lloyd davis position. A bolster is placed at the level of anterosuperior iliac spine which causes elevation of the pelvis. After pneumoperitoneum by veress, total 5 ports are used. Surgical procedure: Uterus was manipulated with a myoma screw. Peritoneal cut was taken at the level of sacral promontory medial to the infundibulopelvic ligament. Ureter and iliac vessels were identified and exposed. Pararectal and paravesical spaces dissected and internal iliac arteries clipped with vascular clips and cut at 4 cm distance from its origin. Prevesical space and and cave of Retzius dissected. Colpotomy done and urethra opened. Ilio-obturator lymph node dissection done using suction cannula/harmonicTM shears. Specimen retrieved vaginally. Vagina was sutured using vicryl 2-0 using continuous interlocking sutures.