Journal CME Article: Pelvic and Perineal Reconstruction-Tubed VRAM flap. Video 3 from “Pelvic and Perineal Reconstruction” October 2024

Tubed VRAM flap. Video 3 from “Pelvic and Perineal Reconstruction” October 2024 – 154 (4) CME

Video Transcription

Video Summary

A 67-year-old woman underwent total pelvic exenteration for recurrent endometrial carcinoma, with planned perineal and vaginal reconstruction using a vertical rectus abdominis myocutaneous flap. The procedure included patency checks of vessels, flap marking, and strategic incisions to preserve vital structures and facilitate closure. The flap was dissected, tubed, and secured intra-abdominally, with deepithelialization as necessary. The neovagina was constructed, and meticulous closure of the perineum and abdominal fascia was performed to prevent complications. The use of ICG angiography ensured flap perfusion, and PDS sutures were utilized for closure.

Keywords

pelvic exenteration

endometrial carcinoma

rectus abdominis flap

neovagina construction

ICG angiography