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  • Title
  • 1. Introduction
  • 2. Cystoscopy and Placement of Bilateral Ureteral Stents and Foley Catheter
  • 3. Incision and Access to the Abdomen
  • 4. Lateral Dissection of Left (Descending) Colon
  • 5. Medial Left/Sigmoid Colon Mobilization
  • 6. Pelvic Extralevator Total Mesorectal Dissection
  • 7. Perineal Extralevator Dissection Posteriorly
  • 8. Total Abdominal Hysterectomy and Bilateral Salpingo-oophorectomy with Total Vaginectomy for Resection of En Bloc Specimen
  • 9. Specimen Examination, Hemostasis, and Irrigation
  • 10. Right Rectus Abdominis Muscle Flap Harvesting
  • 11. Drain Placement in Left Lower Quadrant (LLQ)
  • 12. Creation of Colostomy in LLQ, Pelvic Floor Reconstruction with Right Rectus Abdominis Flap, and Abdominal Wall Closure
  • 13. Colostomy Maturation

Extralevator Abdominoperineal Resection (APR) for Recurrent Anal Cancer With an En Bloc Total Abdominal Hysterectomy and Bilateral Salpingo-Oophorectomy and Total Vaginectomy With Permanent Colostomy Formation and Pelvic Floor Reconstruction Using a Right Rectus Abdominis Flap

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Zoe Garoufalia, MD; Steven D. Wexner, MD, FACS
Cleveland Clinic Florida

General SurgeryObstetrics & GynecologyPlastic SurgeryOncologic SurgeryMultidisciplinary Surgery

Procedure Outline

Table of Contents

  1. 1. Introduction
    1. 2. Cystoscopy and Placement of Bilateral Ureteral Stents and Foley Catheter
      1. 3. Incision and Access to the Abdomen
        1. 4. Lateral Dissection of Left (Descending) Colon
          1. 5. Medial Left/Sigmoid Colon Mobilization
            1. 6. Pelvic Extralevator Total Mesorectal Dissection
              1. 7. Perineal Extralevator Dissection Posteriorly
                1. 8. Total Abdominal Hysterectomy and Bilateral Salpingo-oophorectomy with Total Vaginectomy for Resection of en Bloc Specimen
                  1. 9. Specimen Extraction, Hemostasis, and Irrigation
                    1. 10. Right Rectus Abdominis Muscle Flap Harvesting
                      1. 11. Drain Placement in Left Lower Quadrant (LLQ)
                        1. 12. Creation of Colostomy in LLQ, Pelvic Floor Reconstruction with Right Rectus Abdominis Flap, and Abdominal Wall Closure
                          1. 13. Colostomy Maturation
                            1. IMA Division
                            1. Abdominal Dissection
                            2. Vaginal Dissection
                            1. Dissection of Rectus Abdominis from Anterior Rectus Sheath
                            2. Superior Transection of Rectus Abdominis
                            3. Dissection of Rectus Abdominis from Posterior Rectus Sheath
                            4. Re-approximating Anterior and Posterior Sheaths

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                            Filmed At:

                            Cleveland Clinic Florida

                            Article Information

                            Publication Date
                            Article ID472
                            Production ID0472
                            Volume2025
                            Issue472
                            DOI
                            https://doi.org/10.24296/jomi/472