Didactics-Pelvic exenteration and lateral LEER

Video Transcription

Video Summary

The presentation focused on pelvic exenteration and laterally extended endopelvic resections (LEAR and LEPRA). LEAR, developed by Michael Hockel, is used for treating specific central pelvic recurrences and involves radical removal of pelvic tissues, excising the obturator muscle and internal iliac vessels. LEPRA is more radical, involving additional excision of pelvic sidewall nerves, bones, or major vessels. The speaker detailed the surgical steps of a LEAR procedure, emphasizing the importance of intraoperative assessment and ensuring clear tumor margins. They highlighted the historical context and evolution of exenterative surgeries, their indications, and the role of alternative treatments. The speaker stressed the importance of multidisciplinary team involvement, preoperative patient counseling, and consideration of quality of life outcomes. Additionally, the presentation briefly covered the construction of an ileal conduit, a simpler surgical option for urinary diversion. The speaker concluded with the need for careful case selection and suggested that such complex procedures should be concentrated in centers of national excellence to optimize outcomes.

Asset Subtitle

Dr Raj Naik

Keywords

pelvic exenteration

LEAR

LEPRA

surgical oncology

tumor margins

multidisciplinary team

quality of life

ileal conduit