Robotic-assisted laparoscopic anterior pelvic exenteration in patients with advanced ovarian cancer: Farghaly's...

The safety and efficacy of the robotic-assisted laparoscopic approach to anterior pelvic exenteration is evaluated in patients with advanced ovarian cancer undergoing anterior pelvic exenteration for involvement of the urinary bladder during primary cytoreduction surgery. All patients undergo preoperative lab work, imaging studies and bowel preparation prior to surgery. The Davinci surgical system is used to perform urinary cystectomy, total hysterectomy, bilateral salpingo-oophorectomy, bilateral pelvic adenectomy (including obturator, hypogastic, external iliac, and common iliac lymph nodes). In addition, debulking to less than 1 cm is performed. The anterior pelvic exenteration procedure involves wide perivesical dissection. Then the robot is locked, and ileal conduit is performed via a 6 cm lower midline incision. Operative time can be maintained in 4.6 hours with a mean blood loss of 215 ml and hospital stay of five days. Farghaly's technique of robotic-assisted laparoscopic anterior pelvic exenteration in patients with advanced ovarian cancer is safe, feasible, and cost-effective with acceptable operative, pathological and short- and long-term clinical outcomes. It retains the advantage of minimally invasive surgery.