Amputatio interilio-abdominalis

Amputatio interilio-abdominalis (ipodstore-abdominal amputation) - destruction of the lower limbs and a half of the pelvis.
Indications: the growth of the upper end of the thigh or half of the pelvis, extensive osteomyelitis, echinococcosis, etc. Before surgery down the urine, start intravenous drip blood transfusion and reveal the radial artery for intra-arterial transfusion. Anesthesia combined - endotracheal essential-oxygen anesthesia with sacral anesthesia and neocaesaria major nerve trunks.
The technique of the operation. Patient is placed on his back. The incision begins from the upper posterior iliac spine and lead over the ridge of the iliac bone and papatowai a link to the pubis (Fig). Wide osteotomes prepare the chin from the wing of the Ilium obliques, and from the pubic tubercle - pobertova ligament and tendon of the rectus abdominis muscle. Cut cross fascia, prepare the chin parietal peritoneum to the middle line to Cape sacrum. Following their discharge separately tied up and cross the external iliac artery, vein and femoral nerve (after anesthesia). Lumbar muscle cross the spine.
Leg maximum away. Continue to cut through the perineum to the buttock. From the lower branches pubic and sciatic bones subperiosteal separate the muscles of the perineum. On 1-3 cm from the pubic joint Gigli saw perejivayut pubic bone.
The patient is turn on the healthy side. Cut continue posterior to the back of thigh, buttock crease under the big spit and to the back-top iliac spine. Separate soft tissue from the spit. The resulting massive flap including greater gluteal muscle, they; revealing average gluteal and piriformis muscle with the sciatic nerve. The piriformis muscle cross. Sciatic nerve infiltrate 2% solution novokaina, tightly bandaged silk and cut. After spending through foramen ischiadicum saw Gigli, perejivayut Ilium 2-5 cm from sacroiliac joint. Cross Sacro-awned and sacral-bugrovoy ligaments.
Rotorua leg outwards, naked, tied up and cross locking vessels and nerves. Cut the muscle that raises the anus. Sawed-off part of the pelvis together with the lower limb removed. After hemostasis the wound is sutured in layers tightly. Between the seams enter the drainage. In 2-3 months. the patient can make prosthesis.
Complications: shock, blood loss, and if the damage gluteal vessels - death of the rear flap.

A cut when amputatio interilio-abdominalis: 1 - front; 2 - on the perineum;
3 behind.