Media Release

Udupi, Nov 25: Doctors of the department of Surgical Oncology, Kasturba Medical College and Hospital, Manipal performed a complex limb saving cancer surgery on the pelvic bone of a 45-year-old woman recently. The patient recovered after six weeks of total rest and is walking comfortably after adequate physiotherapy.

The patient had a history of pain and swelling in the lower back. On evaluation, she was diagnosed with tumour of Ilium (part of the pelvic bone) involving the right sacro-iliac joint. The surgery (internal Hemipelvectomy, Type IV resection) was planned after reserving adequate blood components. The important part of the surgery was to identify and safeguard all major nerves and blood vessels, which supply to the lower limb.

The major steps of surgery include dividing the pelvic bone just above the hip joint after protecting the sciatic nerve, cutting the sacral bone lateral to sacral foramina after protecting the lumbosacral trunk. The tumour was removed en-bloc along with sacroiliac joint. The mesh was placed to improve fibrosis and joint stabilization. The skin defect was reconstructed by a local flap. The total duration of the surgery was 10 hrs.

The surgery was performed by Dr Naveena Kumar A N and assisted by Dr Nawaz Usman, Dr Sudhir Varma, Dr Ananth S Mathad from the department of Surgical Oncology. The reconstruction was performed by Dr Srikumar and Dr Joseph from the department of Plastic Surgery, anesthesia was managed by Dr Manjunath Prabu and Dr Yogesh Gaude.

Surgery of this part of the body is challenging because of complex anatomy. In this patient, a complete removal of the tumour as well as saving the limb was a challenge as major blood vessels and nerves of the lower limb travel close to the large tumour. Any injury to these blood vessels may cause major bleeding and can be life-threatening. Any injury to the nerves may lead to permanent weakness of the lower limb.

Dr Avinash Shetty, medical superintendent, Kasturba Hospital, Manipal congratulated the team and said, “This kind of limb saving supra-major surgery is performed only in few centres in India. Currently, the department of Surgical Oncology at Kasturba Hospital, Manipal performs all major and supra-major cancer surgeries and gives new hope to cancer patients of this region.”