Hemipelvectomy Surgery : Resection of Pelvic Bones & Hip Joint

Case of a 41-vear-old male with dedifferentiated
chondrosarcoma (DDCS) of the left iliac bone
post-neoadjuvant chemotherapy (NACT).
* Surgical Highlights:
We performed Type 1+2+3 extra-articular internal
hemipelvectomy with femoral head excision
**Key steps included:
Incision and Flap Management:
-A Tincision was utilized, with the posterior flap raised
incorporating the
gluteus maximus for robust coverage
-Dissection & Preservation: Meticulous dissection
preserved the iliac vessels and sciatic nerve,
minimizing neurological and vascular risks.
-Tumor Resection: Bone Cuts were made at the femoral
neck to remove the femoral head en bloc with the
tumor, ensuring wide margins.
-Reconstruction: A cement-fixed bipolar prosthesis
replaced the femoral head, and the femur was securely
attached to the sacrum using a Trevira tube.
-The implant was braided to prevent hematoma
formation,.
-Perfusion Assessment and Optimization:
Intraoperative Indocyanine green (1CG) dye
fluorescence angiography, aided by Aesculap tools,
confirmed flap
vascularity. Flaps were revised as needed to avert
necrosis, resulting in excellent closure and wound
integrity
****Cases like this underscore the value of advanced
imaging (PET-CT/CT angio) and NACT in enabling
limb-sparing surgery for pelvic sarcomas
*****What are your experiences with similar pelvic
reconstructions & ICG-guided flap assessments?
******Would you opt for alternative implants

Видео Hemipelvectomy Surgery : Resection of Pelvic Bones & Hip Joint канала A to Z of Bone Tumors Dr Abhijeet Salunke