Laterally extended endopelvic resection with external iliac vessels resection and crossover ileofemoral bypass
Abstract
Video Article. Involvement of major pelvic vessels is one of the traditional contraindications of surgical treatment for recurrent gynecologic cancers.
In our experience, ligation of the external iliac vein is also feasible without replacement, though it does however cause transitory severe edema of the lower leg, which can result in chronic lymphedema. The external iliac artery remains an ultimate limit if it is involved in a tumor, and its resection always requires reconstruction.
Video 1 demonstrates a procedure that enables extension of the surgical field beyond traditional limits, with ligation of the common iliac vessels just below the aorta and vena cava bifurcations, resulting in free surgical margins.