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What Is Hemipelvectomy?

Hemipelvectomy is major surgery that removes part of one side of the pelvic girdle, most commonly to treat an extensive pelvic bone or soft-tissue tumor. An internal hemipelvectomy removes affected pelvic bone while preserving the leg. An external hemipelvectomy removes part of the pelvis together with the entire lower extremity on that side. The exact resection depends on tumor location, involvement of major nerves and blood vessels, achievable surgical margins, and the possibility of meaningful limb function.

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What Is Hemipelvectomy?

Hemipelvectomy is major surgery that removes part of one side of the pelvic girdle, most commonly to treat an extensive pelvic bone or soft-tissue tumor. An internal hemipelvectomy removes affected pelvic bone while preserving the leg. An external hemipelvectomy removes part of the pelvis together with the entire lower extremity on that side. The exact resection depends on tumor location, involvement of major nerves and blood vessels, achievable surgical margins, and the possibility of meaningful limb function.

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Why Is Hemipelvectomy Performed?

The procedure is mainly used for selected pelvic sarcomas or other large locally aggressive tumors when wide tumor-free surgical margins require removal of substantial pelvic structures. Internal hemipelvectomy is preferred when the tumor can be removed completely while preserving viable blood vessels, major nerves, and a functional limb. External hemipelvectomy is reserved for situations in which limb salvage cannot provide safe cancer clearance or a viable, useful extremity. Treatment planning requires detailed imaging, biopsy-confirmed diagnosis, and multidisciplinary assessment because pelvic tumors can involve bowel, bladder, vessels, nerves, and other organs.

How Is Hemipelvectomy Performed?

The surgical team removes the involved pelvic bone and surrounding tumor with a planned margin of normal tissue. Internal hemipelvectomy preserves the leg and can be followed by reconstruction with a prosthesis, bone graft, fixation, or no skeletal reconstruction depending on the resection. External hemipelvectomy includes amputation of the lower limb together with removal of the involved hemipelvis and requires formation of a large soft-tissue flap for closure. Vascular, urologic, colorectal, plastic, or other surgical specialists can participate when the tumor involves adjacent pelvic structures.

What Is Recovery Like After Hemipelvectomy?

Recovery is prolonged because hemipelvectomy is one of the most extensive operations used for pelvic tumors. Pain control, wound healing, prevention of blood clots, physical rehabilitation, and treatment of any bowel, urinary, or vascular reconstruction are major early priorities. Patients with internal hemipelvectomy work toward standing and walking with the preserved limb, while patients with external hemipelvectomy learn transfers, mobility aids, and possible prosthetic options. Rehabilitation and functional adaptation can continue for many months after the surgical wound has healed.

What Are the Risks and Complications?

Possible complications include major bleeding, infection, wound breakdown, flap necrosis, blood clots, nerve injury, vascular injury, and damage to nearby pelvic organs. Internal reconstruction can develop dislocation, fracture, implant failure, nonunion, or deep infection and can require additional surgery. External hemipelvectomy carries substantial wound and mobility complications because of the large amputation and soft-tissue defect. Local tumor recurrence and metastatic disease remain possible despite successful resection with clear margins.

Frequently Asked Questions About Hemipelvectomy

What is the difference between internal and external hemipelvectomy?

Internal hemipelvectomy removes pelvic bone while preserving the leg. External hemipelvectomy removes the involved pelvic structures together with the entire leg on that side.

Is hemipelvectomy used mainly for cancer?

Yes. It is most commonly used for large pelvic sarcomas and selected other tumors when less extensive surgery cannot achieve adequate tumor removal.

Can a person walk after internal hemipelvectomy?

Many patients regain some walking ability after rehabilitation, although function depends on the amount of pelvis, muscle, nerve, and joint tissue removed and the reconstruction used.

Why might external hemipelvectomy be necessary?

It can be required when major vessels, nerves, or the limb itself are so extensively involved that limb-sparing surgery cannot achieve safe margins or preserve a viable functional extremity.

References

Comparative study of pelvic sarcoma patients undergoing internal and external hemipelvectomy: A meta-analysis study. PubMed. https://pubmed.ncbi.nlm.nih.gov/36311928/. Date Accessed September 11, 2026.

Reconstruction of Internal Hemipelvectomy Defects After Oncologic Resection. PubMed. https://pubmed.ncbi.nlm.nih.gov/39241189/. Date Accessed September 11, 2026.

Complications of PI to PIII hemipelvic resections for intermediate and malignant tumours: a systematic review and meta-analysis. PubMed. https://pubmed.ncbi.nlm.nih.gov/42219227/. Date Accessed September 11, 2026.

Multidisciplinary Approach to Hemipelvectomy for Pelvic Sarcomas. PubMed. https://pubmed.ncbi.nlm.nih.gov/37544929/. Date Accessed September 11, 2026.

Internal hemipelvectomy with reconstruction for primary pelvic neoplasm: a systematic review. PubMed. https://pubmed.ncbi.nlm.nih.gov/25387591/. Date Accessed September 11, 2026.