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Posterior "Open Book" approach for type 1 internal hemipelvectomy.
John T Stranix1, Neil M Vranis1, Gretl Lam1
11 Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA.
Summary
A novel "posterior open-book" surgical approach improves access for limb-sparing hemipelvectomy, minimizing gluteal muscle injury. This technique enhances pelvic tumor resection and facilitates reconstructive microsurgery.
Area of Science:
- Orthopedic Oncology
- Surgical Oncology
- Microsurgery
Background:
- Internal limb-sparing hemipelvectomy is the standard for pelvic tumor resection.
- Standard ilioinguinal or iliofemoral incisions complicate extensive oncologic operations.
Purpose of the Study:
- To introduce a novel surgical approach for lateral pelvic access.
- To minimize gluteal muscle injury and preserve gluteal vessels.
Main Methods:
- A "posterior open-book" approach is described for lateral pelvic access.
- Skin and soft tissue flaps are reflected anteriorly; gluteal muscles posteriorly/inferiorly.
- This creates a broad, shallow operative field for oncologic resection and microsurgery.
Main Results:
- The technique minimizes tissue reflection, providing optimal exposure.
- It spares gluteal vessels and minimizes injury to gluteal muscles.
- The approach facilitates microsurgical reconstruction with nearby vasculature.
Conclusions:
- The "posterior open-book" approach is a promising alternative for Type 1 hemipelvectomies.
- It offers improved exposure compared to standard incisions.
- Optimizes operative conditions for both oncologic resection and reconstructive procedures.