What is a Hemicorporectomy?

The hemicorporectomy, along with other types of surgery, was developed during and following World War II, due to the need for radical surgical procedures to treat men injured in that war. The procedure was first carried out in 1960; in this case the patient survived only eleven days. It wasn’t until the following year that the procedure was carried out successfully.

Reasons for Hemicorporectomy

In a hemicorporectomy, the body is amputated at a point below the lumbar spine. During this procedure the lower half of the body, including the genitalia, urinary system, pelvis, anus, rectum, and legs, is removed.

Hemicorporectomy is an extremely radical surgery – involving the removal of almost half the body – and as such is performed only in cases of extreme need, when no other solution is available.

This is a “last resort” treatment for people who have undergone extremely traumatic injury, or who have fatal forms of cancer that are not treatable by any other method. Advanced osteomyelitis, a potentially fatal bone infection, may also necessitate this type of radical surgery.

The Hemicorporectomy Procedure

This can be an extremely long procedure, and for this reason it is often carried out in two separate stages. First, the patient’s waste functions are removed and replaced with a colostomy for solid waste, and an ileal conduit for liquid waste.

The second stage of the procedure is the amputation – removal of the patient’s body below the lumbar region. This part of the procedure is carried out so as to leave behind flaps of skin which are used to close the amputation site.

Follow-Up, Risks and Complications

This highly radical surgery has some equally serious consequences, in terms of the patient’s quality of life and in terms of possible complications of the procedure.

For the patient, the consequences of the procedure can be emotional disturbing as well as physically draining. He or she will require extensive occupational therapy and physical therapy, and must also cope with the emotional trauma of having lost half of their body.

Following this type of surgery there are several possible complications and risks. One of the most significant is that with half of the circulatory system gone, the patient’s cardiac health must be monitored closely. Over time, the body develops a new set point for blood pressure, which can be treated or maintained with medication is necessary.

Another possible complication is renal dysfunction, initially due to loss of electrolytes. A large part of the colon and digestive system is removed during the surgery, which impacts on kidney function.

References

Sanford, EJ., Helal, MA., Norman, JG., Karl, RC., and O’Kelly, K. Urological Aspects of Hemicorporectomy British Journal of Urology. Volume 72 Issue 6, pp 915-917

Weaver JM, Flynn MB. Hemicorporectomy. Journal of Surgical Oncology. 2000 Feb;73(2):117-24.

Yancey, AG., Ryan, HF., and Blasingame, JT. An Experience with Hemicorporectomy. J Natl Med Assoc. 1964 July; 56(4): 323–325.