An anatomic approach to tumors of the psoas major muscle

The technique of excision of the entire psoas major muscle via the retroperitoneal route is described. This approach prevents direct seeding of the peritoneal cavity with tumor cells and provides relatively easy access to the entire psoas major muscle and its blood supply. The anatomic characteristics of the retroperitoneal space preclude wide surgical margins in whatever approach is used, and in this regard the retroperitoneal approach is probably no more difficult than the transperitoneal approach. The relative ease with which a primary tumor in the psoas major muscle can be excised makes the retroperitoneal approach desirable from the surgeon's point of view.