Hemicorporectomy

Hemicorporectomy
Pronunciation	/ˌhɛmiˌkɔːrpəˈrɛktəmi/
Synonyms	translumbar amputation, corporal transection, hemisomato-tmesis, halfectomy
ICD-10-PCS	S38.3
MeSH	D006428
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Hemicorporectomy is a radical surgery in which the body below the waist is amputated, transecting the lumbar spine. This removes the legs, the genitalia (internal and external), urinary system, pelvic bones, anus, and rectum. It is a severely mutilating procedure recommended only as a last resort for people with severe and potentially fatal illnesses such as osteomyelitis, tumors, severe traumas and intractable decubiti in, or around, the pelvis. It has only been reported a few dozen times in medical literature.

The nomenclature is somewhat at odds with generally accepted anatomical terms, as hemi is generally used to refer to one of two sides (e.g., hemiplegia, which affects the arm and leg on one side of the body). In that sense, paracorporectomy might more closely reflect the nature of the procedure.

The operation is most often performed to treat spreading cancers of the spinal cord and pelvic bones. Other reasons may include trauma affecting the pelvic girdle ("open-book fracture"), uncontrollable abscess or ulcers of the pelvic region (causing sepsis) or other locally uncontainable conditions. It is used in cases wherein even pelvic exenteration would not remove sufficient tissue.

The surgical procedure is often done in two stages, but it is possible to conduct the surgery in one stage. The first stage is the discontinuation of the waste functions by performing a colostomy and ileal conduit. The second stage is the amputation.

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