The Inferior Gluteal Artery Myocutaneous Flap with Vascularized Fascia Lata to Reconstruct Extended Abdominoperineal Defects

Abstract

Therapeutic, IV.

Robotic beyond total mesorectal excision surgery for primary and recurrent pelvic malignancy: Feasibility and short‐term outcomes

“…When urinary reconstruction was necessary, nonsuction drains were left in place around the conduit or ureteric reimplantation sites. In nonrestorative cases, when reconstruction was deemed necessary to cover the perineal defect, an inferior gluteal artery myocutaneous flap was fashioned [15].…”

“…M, mesorectum; S, sacrum F I G U R E 2 View of the resection bed after an ultra-low anterior resection with en bloc right pelvic sidewall excision including the right internal iliac system and pelvic sidewall lymphatic tissue with preservation of the ureter (blue sling) and obturator nerve. EIV, external iliac vein; IIA, internal iliac artery; OM, obturator muscle; ON, obturator nerve; U, ureter deemed necessary to cover the perineal defect, an inferior gluteal artery myocutaneous flap was fashioned [15].…”

“…The two patients that did not have neoadjuvant treatment had a background of radiation or chemoradiation treatment: one for prostate cancer and the other as initial treatment for an anal SCC. The median time from completion of LCCRT to surgery was 14 [11][12][13][14][15][16] weeks.…”

Towards Standardisation of Technique for En Bloc Sacrectomy for Locally Advanced and Recurrent Rectal Cancer

“…Abdominal wall flaps, such as the vertical rectus abdominis myocutaneous flap (VRAM), are often difficult in the setting of exenteration as a result of bilateral stomas but may be favoured by those using an abdominoperineal approach. When resection is completed using the prone approach, the inferior gluteal artery perforator flap appears to be the obvious reconstructive option, using the generous volume of the gluteal muscles [ 31 , 32 , 33 ]. Their major drawback is their risk of devascularisation in the setting of internal iliac vessel sacrifice as part of high sacrectomy [ 7 ].…”

“…Laparoscopic en bloc sacrectomy has been described, using a Gigli saw with wires through caudal trocars to divide the sacrum [ 37 ], and a similar robotic approach may be feasible. Alternatively, the abdominal portion could be completed using a minimally invasive approach, with the sacrectomy completed using the perineal or posterior approach; however, to date, there are no reports of these [ 30 , 31 , 32 , 33 ].…”