Hemipelvectomy

Hemipelvectomy is typically indicated in severe cases where less radical surgeries are not feasible. The most common indications include:

• Malignant Tumors: This is the most frequent reason for hemipelvectomy. Cancers such as osteosarcoma, chondrosarcoma, or Ewing’s sarcoma that are localized to the pelvic bones but have not spread widely to other parts of the body may require this surgery.
• Metastatic cancer: High tumor burden and pain in the pelvis may require a more aggressive approach.
• Severe Trauma: In cases of severe pelvic trauma where reconstruction is not possible, hemipelvectomy might be performed to save the patient’s life.
• Chronic Infection: Rarely, if an infection in the pelvic area is so severe that it cannot be controlled by other means, hemipelvectomy may be indicated.
• Non-malignant but aggressive conditions: Some aggressive benign tumors, such as giant cell tumor of bone, aneurysmal bone cyst, osteoblastoma, or others may also necessitate this surgery.
• Palliative Care: In some cases a hemipelvectomy may be performed to extend the quality of life of a patient.

Reconstruction involves the use of tissue grafts to recreate the pelvis and protect the remaining structures and screws and plates, after an internal hemipelvectomy.

A hemipelvectomy is one of the rarest procedures performed and is challenging to perform. Dr. Matthew Colman has the knowledge, expertise, and experience to perform this procedure.

Recovery from hemipelvectomy is prolonged and involves multiple stages:

• Initial Recovery: Patients usually spend several days to weeks in the hospital. Pain management, wound care, and monitoring for complications such as infection or blood clots are critical during this period.
• Rehabilitation: Extensive physical therapy is required, especially for patients who undergo external hemipelvectomy. This may include learning to use a prosthesis, regaining strength, and adapting to new ways of performing daily activities.
• Psychological Support: Given the significant impact on body image and function, psychological support is often an essential part of recovery.

Hemipelvectomy is a complex and radical surgery primarily indicated for the treatment of malignant pelvic tumors and severe trauma. While it carries significant risks, including infection, blood loss, and mobility challenges, it can be life-saving and provide effective disease control. The success of the procedure depends on various factors, including the underlying condition, the extent of surgery, and the patient’s post-operative recovery and rehabilitation efforts.