Introduction/Background*Vulvar cancer is a rare disease specially in young women. When a large tumour is diagnosed, reconstruction flap should be considered in order to achieve the best cosmetic and functional result.

Methodology This surgical video shows the excision of a perianal recurrence secondary to a vulvar cancer after primary radiotherapy. Rectal amputation and terminal colostomy were performed through a laparoscopic approach. A bilateral V-Y flap was designed for perineal reconstruction. This procedure was recorded step by step.

Result(s)*A 47 years old woman was diagnosed with perianal VIN III. It measured 25mm and had no extraperineal disease. Primary radiotherapy was indicated due to the invasion of anal mucosa. After 6 months of treatment, perianal recurrence of scamous vulvar carcinoma was diagnosed. Consequently, wide surgical excision, anal amputation, bilateral V-Y flap reconstruction and terminal colostomy were performed under lithotomy position and general anaesthesia. Despite surgical wound infection by pseudomonas and partial dehiscence, very good cosmetic and functional results were achieved.

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Abstract 1021 Figure 1

Conclusion*V-Y flap reconstruction may be a good option for the treatment of perineal defects that are too large for primary intention wound closure.