A surgical technique for buttockectomy.

The buttockectomy is an en bloc resection of the gluteus maximus muscle and is usually performed for low-grade malignancy tumors of the buttocks that are encompassed by the muscle excised. After the incision of the skin widely around the tumor, skin flaps are created to expose the entire gluteus maximus muscle; the inferior rolled edge of the muscle is identified and traced laterally to its insertion on the iliotibial tract. For a left buttockectomy the operator proceeds clockwise, first releasing the insertions of the muscle from the iliotibial tract and greater trochanter and the origins from the crest of ilium and sacrum. For a right buttockectomy one proceeds in a counterclockwise fashion, again starting at the inferior aspect of the gluteus maximus muscle. Care must be taken to avoid damage to the sciatic nerve and to secure the inferior and superior gluteal vessels before they are transected. Suction drainage is secured to remove serum and ensure adherence of skin flaps to the resection site. If the skin closure is tight, retention sutures may be needed.