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Surgeons completely rebuild pelvis of cancer patient

May 6, 2011 - Washington

A multi-disciplinary team of surgeons has completely rebuilt the pelvis of cancer patient.

Surgeons at the Ohio State University Comprehensive Cancer Center, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James) conducted the operation.

The surgeons removed the left leg, hip and pelvis of a cancer patient, and used the healthy, living bones from his amputated leg to completely rebuild the connection between his spine and remaining right pelvis to support a high-tech prosthetic leg.

Dr. Joel Mayerson, an orthopaedic oncologist collaborated with a surgical team that included Dr. Ehud Mendel, a spine neurosurgeon, and Dr. Michael Miller, a plastic surgeon, who specializes in reconstructive surgical oncology.

"This procedure itself is actually the first time it's ever been performed in the United States," Mayerson said.

The surgery is called an "En Bloc" procedure, which translated from French means "as a whole, or in mass," meaning that the surgeon must remove the entire tumour intact.

The surgical team removed the tumour and worked together to design a method to rebuild the patient's pelvis using titanium supports along with parts of the patient's leg - including bones, muscles, skin and blood vessels.

"Removing the tumour required removing the leg, yet many of the tissues in the leg were healthy," Miller, interim chair of Ohio State University Medical Center's Department of Plastic Surgery, said.

"We wondered if it was possible to use the healthy parts of the patient's leg to reconstruct his pelvis," he stated.

The custom device that Mendel fashioned features two large rods and a couple of smaller rods fixed to the pelvis and spine with 14 screws to help provide support while the leg bones fused together.

The Ohio State surgery marked the first time that surgeons used living bone from the patient's amputated limb to reconstruct the pelvis in this fashion.

This allowed the bones to fuse together to create an intact pelvic ring strong enough to allow the patient to walk again on a prosthetic leg, according to Mayerson, director of the division of musculoskeletal oncology in the department of orthopaedics.

"Once you disrupt the pelvic ring to the extent done in this case, the stability of your spine connected to your pelvis is not nearly as good," Mayerson said.

"The surgical team came up with a way to reconstruct the patient's pelvic ring to provide solid support, so that he could be as active as possible," Mayerson added.

The surgery and recovery proved successful with no major complications.

The pelvic reconstruction surgery was so unusual that the surgical team submitted it as a case study to the Journal of Neurosurgery: Spine, which recently published it online.


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