Background: Surgery was performed via the vaginal route on a morbidly obese and medically compromised woman with an enlarged uterus, possibly caused by endometrial cancer. Case: To debulk the uterus, suction curettage was performed after bisecting the cervix, and complete vaginal surgery was performed with zero contamination of healthy tissues. Results: The postoperative period was uneventful. Histopathology confirmed the presence of < ½ myometrial invasion and endometrioid adenocarcinoma of the endometrium with normal or uninvaded vaginal cuff, tubes, and ovaries. Conclusions: When feasible, safe intraoperative debulking should be considered, to enable use of the vaginal route for surgery on a woman with endometrial cancer, to spare her from the more morbid abdominal route. (J GYNECOL SURG 28:67)
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