Pelvic exenterative surgery for palliation of malignant disease in the robotic era.

A Medline-based literature review was carried out of the surgical management of advanced pelvic cancers and the effect of minimally invasive technology in this setting to review the current status of exenterative surgery for advanced pelvic malignancies. Palliation and/or resection of advanced pelvic cancer affecting one or more pelvic compartments offers benefit and improved quality of life in carefully selected patients. This complex surgery is best carried out by experienced multidisciplinary teams after meticulous preoperative staging and assessment. Survival rates at 5 years are between 25 and 40% in the absence of metastatic disease and between 18 and 24 months in the palliative setting. Open surgery remains the gold standard approach, but emerging reports of laparoscopic and robotically assisted laparoscopic techniques may be feasible in highly selected individuals.