Pelvic Exenteration Surgery in Delhi, India

Pelvic exenteration is a surgical procedure to remove various organs in the pelvic region in case of recurrent cancers. This technique is used to remove the bladder, reproductive organs such as uterus, cervix, vagina, and parts of the gastrointestinal tracts such as rectum, or anus. Pelvic exenteration is major surgery and is done under general anesthesia. It is performed only when cancer has not spread to other parts of the body.

Gynecological cancers and gastrointestinal cancer that may be treated with this surgery include:

• Vaginal cancer
• Uterine cancer
• Cervical cancer
• Vulvar cancer
• Rectum cancer
• Anal cancer

Body Location

Organs in the pelvic region (e.g. uterus, colon, rectum, reproductive organs)

Alternate Name of Pelvic Exenteration Surgery

Radical pelvic exenteration

Pelvic Exenteration Procedure Type

Surgical

Preparation for Pelvic Exenteration Surgery

• Before undergoing pelvic exenteration, it is crucial to prepare and understand the outcomes and expectations. Your surgeon will recommend you to undergo certain blood tests and a pre-anesthesia check-up (PAC) that would also include a chest X-ray, electrocardiogram (ECG) along with a physical examination to assess your suitability for the surgery. You will also undergo imaging tests to assess the spread of cancer and the location of the surgery.
• You should eat light food the day before surgery and fast for at least 6-8 hours before the surgery, to avoid complications during the surgery.
• Inform your doctor about all your medications and you could be asked to discontinue blood-thinning medications. Also, you could be prescribed certain medications to calm your nerves.
• You should reach the hospital 4-6 hours before the surgery as you will be kept under observation for some time.

Pelvic Exenteration Surgery Procedure

Pelvic exenteration is performed under sedatives and anesthesia to block the pain and sensation. A few small incisions are made in the abdominal wall. A laparoscope (instrument with a small camera) is inserted through one of the incisions to create images for guiding the surgeon to and examine the pelvic region and abdominal cavity.

A larger cut is made and the affected tissues or organs are removed could include the reproductive organs, bladder, lymph nodes & parts of the rectum. Following the removal of cancerous tissue/organ, reconstruction is done to restore various body functions depending upon the location of the surgery. These could include reconstructing the vagina, urinary diversion, or colostomy (for passing stools).

Recovery After Pelvic Exenteration Surgery

Depending on the site of the surgery, you will be transferred to the recovery room after a few hours to a couple of days. Once your vital signs have stabilized, you will be shifted to the hospital room/ward and within a few days, you will be discharged from the hospital.

The recovery will take a few weeks and you can slowly start returning to your normal activities. While you are in recovery mode, avoid housework for a few weeks that could stress your body. Walking and breathing exercises are imperative for quick recovery and avoiding complications. Getting regular follow-ups done per the schedule is also crucial to achieving a complication-free recovery.

Take good care of the incision wounds and keep them clean. Take your medications including painkillers, and antibiotics as prescribed. If you experience unexplained pain, excessive vomiting, or any other side effects, seek medical attention.

Follow-up After Pelvic Exenteration Surgery

You should continue with your follow-ups as per the schedule for a complication-free recovery. Usually, your surgeon will give a follow-up chart to follow until your incision wounds have healed. In addition, you should take proper rest as recommended by your doctor and do not overexert yourself. Avoid housework and seek help from your family members or friends. You can start returning to your routine activities in a few weeks. Wear loose clothes and eat nutritious food. Keep your wounds clean and dry. You should check with your doctor regarding the bathing. Look for any signs of infection, swelling, or redness at the incision site. Take your medication as prescribed, and drink plenty of water and oral fluids.

Risks Associated with Pelvic Exenteration Surgery

Being a major surgery, there are various risks associated with pelvic exenteration such as:

• Bleeding from the incision site or surrounding organs
• Incision site infections could occur and you might need antibiotic treatment following the surgery.

In addition, surgery could be associated with the following side effects:

• Damage to an adjoining organ
• Vaginal dryness
• Recurrent urinary tract infection
• Bowel changes
• Blood clot formation
• Postoperative pneumonia
• Wound separation
• Fistula formation
• Hypersensitivity reaction to anesthesia.

Frequently Asked Questions

1. How much does pelvic exenteration cost in India?

The cost of pelvic exenteration in India can vary depending on factors such as the hospital, surgeon, location, and additional medical expenses. It is best to consult with specific hospitals or healthcare providers for accurate cost information.

2. What is life expectancy after pelvic exenteration?

Life expectancy after pelvic exenteration varies based on the individual's overall health, the stage of the disease, and other factors. It is best to discuss this with the medical team involved in the treatment.

3. Is pelvic exenteration rare?

Pelvic exenteration is considered a rare surgical procedure due to its complex nature and the specific conditions for which it is performed.

4. How successful is pelvic exenteration?

The success of pelvic exenteration depends on various factors such as the extent of the disease, individual patient factors, and the expertise of the surgical team. The overall success rates can vary and should be discussed with the healthcare provider.

5. How do you pee after pelvic exenteration?

Urinary reconstruction after pelvic exenteration may involve creating a new pathway for urine to exit the body, such as a urostomy or neobladder. The specific method depends on individual factors and surgical techniques.

6. What is the alternative to pelvic exenteration?

Alternative treatments to pelvic exenteration depend on the underlying condition. These may include radiation therapy, chemotherapy, targeted therapy, or other surgical approaches tailored to the patient's needs.

7. What are the risks of pelvic exenteration?

Risks of pelvic exenteration include infection, bleeding, damage to surrounding organs or structures, blood clots, urinary or fecal incontinence, sexual dysfunction, and complications associated with anesthesia. Consult with a healthcare provider for a comprehensive understanding of the risks.

8. Why is a pelvic exenteration done?

Pelvic exenteration is typically performed to treat advanced or recurrent pelvic cancers that involve the organs in the pelvis. It may be considered when other treatments have not been successful or when there is a high risk of disease progression.

9. Is pelvic exenteration surgery risky?

Pelvic exenteration is a complex surgical procedure that carries risks and potential complications. The decision to undergo the surgery should be based on a thorough evaluation of individual risks, benefits, and alternatives, in consultation with a healthcare team.

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