Patient with ovarian cancer recurrence after postoperative chemotherapy and again obtained radical surgery, 52 years old, recurrence of ovarian cancer after postoperative chemotherapy and tumor progression after chemotherapy again. The abdomen was soft and the tumor was palpable on rectal palpation and vaginal stump palpation, and the anterior vaginal wall was normal for 5 cm. Today, in the dissection, there was no tumor in the upper abdomen, and the tumor was located in the pelvic cavity invading the rectovaginal stump, which was closely related to the right pelvic wall. Rectosigmoid resection (Dixon procedure) and ileostomy of the vaginal stump were performed. Intraoperative points: 1 Separation of vaginal stump, usually peeled or cut with scissors, the scissors have sensation and should not split the posterior bladder wall. 2 Left hand into the vagina as a guide to avoid separation of the wrong layer. 3 Prevention of leakage of vesico-vaginal stump. Due to postoperative chemotherapy, the posterior bladder wall is adherent and thinned after separation, and vesicovaginal stump leakage may occur. If the patient has a large omentum, the large omentum is available, but this patient’s large omentum was excised. In this patient, the splenic flexure colon was freed and the wide colonic mesentery did not need to be excised. The excess colonic mesentery was sewn to the vaginal stump to enhance the posterior bladder wall to isolate the vesicovaginal space and prevent vesicovaginal leakage. Wang Gangcheng, Department of General Surgery, Henan Cancer Hospital