This 41yro female presented with a right labial lesion. A biopsy was taken and the results were reported as VIN III, cannot rule out invasion. The decision was therefor made to proceed with wide local excision of the right vulva.

Procedure: The patient was taken to the operating room and general anesthesia was administered. The patient was then prepped and draped in the usual manner in lithotomy position, and the bladder was emptied with a straight catheter. The vulva was then inspected. On the right labium minora at approximately the 11 o'clock position, there was a multifocal lesion. A marking pen was then used to mark out an elliptical incision, leaving a 1-cm border on all sides. The skin ellipse was then excised using a knife. Bleeders were cauterized with electrocautery. A running locked suture of 2-0 Vicryl was then placed in the deeper tissue. The skin was finally reapproximated with 4-0 Vicryl in an interrupted fashion. Good hemostasis was thereby achieved. The patient tolerated this procedure well. There were no complications.

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