Pelvic Reconstruction After Cancer Extirpation

With advancement in knowledge, techniques and cancer treatment, resecting cancer surgeons are now performing increasingly complex extirpations of pelvic tumours. These tumours can arise from tissues such as the large intestine, the sacrum, or the prostate. Strong reconstructive support has also enabled these large resection procedures, as the resultant defects can leave a significant wound and dead space. If inadequately reconstructed, there is a high risk of wound breakdown and herniation.

The plastic surgeon’s role in these cases is to provide robust support to the pelvis, sealing off visceral contents from the surface and enabling the patient to return to normal mobility and as close to normal function as possible. This is usually done using meshes and/or the patient’s own tissue in the form of pedicled flaps from the buttock, abdomen, or thighs. Each form of reconstruction has its own benefits and drawbacks. Your plastic surgeon will discuss these options with you to determine the recommended course of action.

With minimally invasive robotic surgery increasingly being used in complex cases, there are instances where dead space does need to be obliterated where there are no external access points apart from small robotic ports. Dr Adrian has been trained in robotic reconstruction, and together with the resecting surgeon can perform reconstruction without the need for external scars, utilizing the rectus abdominis muscle internally. This scarless approach is truly the ultimate in terms of pelvic resection and reconstruction.