I was curious as to what the most extreme surgical procedures were.
In looking this up, I found one procedure called a hemicorporectomy, where (as I understand it) the entire lower half of the body (from the pelvis on down) is removed.
How many such operations are performed say every year in the United States and the rest of the world?
(And yes, I realise that there’s only one operation of this type per person.)
Are there any surgical procedures even more extreme than a hemicorporectomy?
I stumbled across this myself a short while back. There certainly can’t be many cases of it – the times when it would be desirable and profitable to perform it must be severely limited.
the Wikipedia page referencing it has a link to a blog being kept by a man undergoing this procedure.
Until they really do get around to keeping alive head a la Futurama or cheesy horror films, I find it hard to imagine a more radical surgery.
As a last resort in severe life-threatening cases of epilepsy, sometimes an entire hemisphere of the brain is removed. The remarkable thing is that a person can live a mostly normal life after this!
FWIW, I can’t find a code for hemicorporectomy in the ICD (International Classification of Diseases) system, which says to me that it’s vanishingly rare.
I’ve seen someone in a wheelchair who appeared to have had a hemicorporectomy. I’m glad to know more about this, I thought it was some horrendous birth defect, although the person didn’t appear impaired in any way but physically.
I gave the anesthesia for a hemicorporectomy back in the middle 70’s. It was done at Memorial Sloan-Kettering although the man did not have cancer. This was a relatively young man who had been a paraplegic for half his life. He had developed a large sacral bedsore that would not heal, frequently became infected despite heroic care, and caused the poor guy constant pain. Even back then, it took a long search to find a hospital and a doctor willing to do such a radical procedure. They insisted on several months of pre-op psychotherapy to make sure he was mentally prepared (as much as one can be for having them cut off half your body and give you stomas and bags for urine and feces). Ambulating was easier after surgery with all that dead weight gone. He was quite pleased with much easier movement and virtually complete pain relief. Go figure. Very nice guy.
We did a lot of horriblectomies for cancer at that place. The ones that freaked me out were the face-ectomies for recurrent sinus cancer. They would remove more than half of someone's face including one eye, the cheek, the jaw, the forehead - everything. Then they would cover the hole with a big flap of flat skin. The idea was to let it heal for a few months before starting the marathon of reconstructive surgeries. **OMG!!!!** Of course they only did this on people who really begged them to make sure they were cured. Not too many people did - I mostly remember a couple of young mothers who wanted to make sure they could watch their children grow up.
A similar birth defect does appear to be like this (so you might have seen such a case). The mosyt famous example was Johnny Eck, who appeared in the Todd Browning film Freaks and elsewhere:
http://www.johnnyeckmuseum.com/
Johnny used to put “covers” on his hands and run around on his hands like they were feet. He had a identical twin brother who was normal, and the two of them worked with a magician on a “sawing a man in half” illusion thatmust have been a killer – Johnny came out and ran around on his hands after being sawn in half. (A midget dressed in special pants that concealed his top half ran around as the bottom half.)
Does anyone know what Johnny Eck’s anatomy was like? One website said he did have small stumps for legs… were his internal organs all present and accounted for, just somehow compressed into a smaller area? It’s very curious! The pictures of him are truly amazing.
There was a pair of performers known as Bowen and Tripp (sp?). One was armless and one was legless. The legless one did, though, have feet at the bottom of the torso. Sometimes people would ask what happened to his legs and he’d say he lost them in an injury, and they’d say well why do you have feet, and he’d say they didn’t get hurt.
While not the most extreme procedure, pelvic extenteration comes close. If nothing else, it’s relatively common. As the link notes, this operation involves removing all abdominal/pelvic contents south of the belly-button.
As a student, I assisted at a couple of these O.R.s. The thing that stands out in my mind is that there were two teams of surgeons - one working from above (through the abdomen), and another working from below (through the perineum), and then, like a scene from the meeting of the first transcontinental railroads, there was daylight between them. They met at the half-way point - there was nothing left to get in the way. :eek:
There is a phenomena known as “internal decapitation” where the uppermost part of the spinal column breaks, basically detacting the skull from the rest of the skeleton but leaving the muscle, skin, etc. intact. A very few people have survived that - a very few.
There is/was a show on TLC or Discovery Health, something like that, called “Surgery Saved My Life.” One episode featured a young woman named Gretchen Miller who had not eaten for 14 years because she had had some sort of damage to her intestines, with the result that her digestive system had pretty much shut down. She got her nutrition through a tube, but she was skeletally thin and terribly yellow. She needed a six-organ transplant and had had several potential donors, but the trouble was that someone who had a higher-priority need for, say, a liver would get that organ, so because she needed the whole set she was out of luck. Finally on something like the sixth try she got the whole set of organs – but because of the timing to go get them, the surgeons had to start removing her organs before the new ones were there. So if the plane crashed or anything happened to delay the organs, she would die. The program showed her abdominal cavity after they removed the last organ – just a big hollow cavity below her diaphragm. Very weird and freaky.
She did get her organs, and the “after” images of her were just beautiful. Face filled out, normal color, very happy. She had nieces and nephews who had never known her to be anything but sick. The transformation was amazing.