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Doctors reading scan before surgery

A hemipelvectomy is a surgical procedure that may be performed to address certain bone and soft tissue tumors that developed in or spread to the pelvis. An uncommon type of lower-extremity, above-the-knee amputation, hemipelvectomy involves the removal or resection of the pelvis. Usually, this procedure is considered only after other treatments, such as chemotherapy or radiation therapy, do not produce satisfactory results.

How is a hemipelvectomy performed?

When performing a standard hemipelvectomy, a surgeon makes a large incision either in the perineum or at the back of the patient’s body near the ilioinguinal nerve. The surgeon then removes the tumor along with a margin of surrounding healthy tissue, which is analyzed in a lab for evidence of cancer spread. Depending on the pathology results, the surgeon may remove additional tissue.

Surgical reconstruction is standard following any lower extremity amputation, including a hemipelvectomy. Usually, this involves a skin-transplantation graft or flap procedure to recreate the pelvic area and protect the remaining structures as well as any attached metal screws or plates.

How does a hemipelvectomy differ from a hip disarticulation?

A hip disarticulation procedure is similar to a hemipelvectomy procedure in that both involve the removal of the three lower limb joints: the hip, knee and ankle. However, a key distinction between the two is that a hip disarticulation involves the removal of the entire lower limb through the hip joint, while a hemipelvectomy involves the removal of the entire lower limb at the hip along with a pelvic amputation.

As such, a hip disarticulation procedure preserves the ischium, a weight-bearing bone that can serve as a stable area for mounting sockets to support a lower-extremity prosthetic system. Conversely, a hemipelvectomy procedure does not preserve the ischium on the side of the pelvis where the procedure was performed. As a result, weight is distributed through the soft tissues surrounding the hip and pelvis to the other side of the pelvis where the ischium remains.

If you are considering a hemipelvectomy procedure and you have questions, you are welcome to talk with a specialist in the Sarcoma Program at Moffitt Cancer Center. To request an appointment, please call 1-888-663-3488 or complete our new patient registration form online.