During performance of bilateral groin incisions, an abdominal incision and a colostomy has the potential risks of devascularization of the lower abdominal wall and infection. A patient with locally advanced vulvar carcinoma requiring a posterior exenteration is presented. The posterior exenteration was performed by developing an abdominal skin flap from the groin incisions. This approach offers adequate exposure and a unique solution to the potential problems associated with combining an abdominal skin incision with bilateral groin incisions and end-descending sigmoid colostomy. In addition, this approach may be cosmetically more acceptable.