The cancer was deep: osteosarcoma in the pelvis, a massive clump in a hard-to-reach spot. It lay in the bone beneath inches of skin, fat and muscle, tucked behind organs interlaced with major arteries.
Faced with this diagnosis, most doctors would take the low-risk option. They’d slice through the belly, travel into the the pelvic area, and carve out the tumor freehand. On the way out, they’d do a so-called internal amputation, repairing what damage they could. This tried-and-true maneuver might save the patient, but the leg would no longer function.
Two doctors at NYU’s Langone Medical Center had a different idea. Timothy Rapp and Pierre Saadeh wondered if they could cut in not from the front, but from behind. They’d maneuver their instruments past the veins and the fat, the muscles and nerves. They’d extract the massive chunk of cancerous bone. But then would come the hard part. To save the patient’s ability to walk, they’d have to somehow fill the hole.