Vaginal reconstruction following supra-levator total pelvic exenteration.
BACKGROUND
There are several available techniques for neovaginal reconstruction following exenterative gynecologic surgery. However, all methods are associated with prolonged operative time and increased morbidity. The Apogee and Perigee vaginal vault and prolapse repair systems are innovative and minimally invasive procedures that may prove to be effective in controlling the levator defect and reconstructing the vagina in patients undergoing supra-levator pelvic exenteration.


METHODS
We present a patient who underwent supra-levator total pelvic exenteration for treatment of recurrent squamous cell carcinoma of the cervix. Vaginal reconstruction was performed with the Apogee and Perigee systems utilizing the porcine mesh (InteXen) from American Medical Systems. The patient did well without any postoperative vaginal or small bowel complications.


CONCLUSIONS
The Apogee and Perigee systems comprise an innovative technique for vaginal vault reconstruction and prolapse repair. These systems may prove useful in reconstruction of the pelvis following ultra-radical pelvic procedures for recurrent gynecologic malignancies.
Gynecologic Oncology Associates, Hoag Cancer Center, 351 Hospital Road, Suite 507, Newport Beach, CA 92663, USA. bram@gynoncology.com
Mark A
MA
Rettenmaier
Bram H
BH
Goldstein
John P
JP
Micha
John V
JV
Brown
D000818:Animals; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010385:Pelvic Exenteration / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013526:Surgical Mesh; D013552:Swine; D002583:Uterine Cervical Neoplasms / Q000601:surgery*; D014621:Vagina / Q000601:surgery*