Exenterative Surgery

Pelvic exenteration is a salvage procedure performed for centrally recurrent gynaecological cancers. To a greater or lesser degree, the procedure involves en bloc resection of all pelvic structures, including the uterus, cervix, vagina, bladder, and rectum. Most candidates for this procedure have a diagnosis of recurrent cervical cancer that has previously been treated with surgery and radiation or radiation alone. In some cases, patients with recurrent uterine, vulval, or vaginal cancers may benefit from pelvic exenteration.

There are three types of female pelvic exenteration: anterior, posterior and total.

1. Anterior pelvic exenteration: removal of reproductive organs and bladder your bladder
2. Posterior pelvic exenteration: removal of reproductive organs and portion of your intestines 
3. Total pelvic exenteration: removal of   reproductive organs and the organs in your urinary system and digestive system. These include your:

• Anus, the opening that carries stool (poop) out of your body.
• Bladder, the muscular pouch that collects urine (pee).
• Colon, the longest part of your large intestine.
• Rectum, the last few inches of your large intestine.
• Urethra, the tube that carries urine out of your body.

This is a highly complex and lengthy surgery that is reserved for women with recurrent disease that are able to undergo such an operation. This surgery often involves surgeons of different specialties including urologists, colorectals, and plastic surgeons. 

Excellence in Surgical Care

Dr. Tranoulis is highly experienced in the treatment of gynaecological cancers and a recognised leader in his field. International studies have demostrated that surgeons performing higher volumes of particular procedures can often offer patients better outcomes, such as shorter hospital stays and fewer complications. Exenterative surgery is a complicated surgery that should only be performed by highly skilled, experienced surgeons on patients who have been carefully selected for the procedure. Dr. Tranoulis is a Certified Gynaecological Oncologist with further sub-specialisation in exenterative procedures at the prestigious Basingstoke Peritoneal Malignancy Institute and The Pan-Birmingham Gynaecological Cancer Centre, where a high volume of such procedures is performed. 

Dr. Tranoulis will carefully review your medical records and meet with you to determine if this operation may be an effective treatment for you. Two factors are critical for successful outcomes: First, careful patient selection to determine who may benefit the most with the least amount of risk, and second, performance of this operation by a Surgical Oncology Team experienced in exenterative procedures.