Minim Invasive Neurosurg 2007; 50(1): 33-36
DOI: 10.1055/s-2007-970075
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Laparoscopic Neurolysis of the Sacral Plexus and the Sciatic Nerve for Extensive Endometriosis of the Pelvic Wall

M. Possover 1 , J. Baekelandt 1 , C. Flaskamp 1 , D. Li 2 , V. Chiantera 3
  • 1Department of Obstetrics and Gynecology, St. Elisabeth Hospital, Cologne, Germany
  • 2Department of Gynecology, Yue Yang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
  • 3Department of Gynecology and Obstetrics, II University of Naples, Naples, Italy
Further Information

Publication History

Publication Date:
04 June 2007 (online)

Abstract

Background: The aim of this study is to report on the feasibility of laparoscopic neurolysis of the plexus sacralis and the sciatic nerve in deep endometriotic infiltration of the lateral pelvic wall.

Methods: A transperitoneal approach to the pelvic nerves combined with the LANN technique for intraoperative assessment of the function of the exposed nerves permit exposure and sparing of all somatic nerves during resection of the endometriotic lesion.

Results: We report on our short experience with 21 patients who underwent this technique for the treatment of endometriotic infiltration of the sacral plexus at different levels.

Conclusion: In young patients with chronic unilateral sciatica or unilateral pudendal neuralgia - Alcock's canal syndrome - where no neurological/orthopedic etiologies have been found, endometriotic infiltration of the lateral pelvic wall has to be implicated as a potential etiology and an indication for laparoscopy must be discussed. Laparoscopic neurolysis of the pelvic somatic nerves is a feasible procedure for trained laparoscopic surgeons who have a good knowledge of the retroperitoneal pelvic (neuro)anatomy.

References

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  • 2 Possover M, Quakernack J, Chiantera V. The “LANN technique” for reduction of the postoperative functional morbidity in laparoscopic radical pelvic surgery.  J Am Coll Surg. 2005;  201 913-917
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  • 6 Possover M, Chiantera V, Baekelandt J. Anatomy of the sacral roots and the pelvic splanclinic nerves in women using the LANN-technique,.  , in press 2007
  • 7 Possover M. The “neurologic hypothesis”, a new concept in the pathogenesis of the endometriosis?.  Gynecol Surg Endoscopy Imaging and Allied Technique 2005;  2 107-111
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1 Disclaimer
No financial support was received for this study and there is no conflict of interest.

Correspondence

Prof.Dr. M. Possover

Department of Obstetrics and Gynecology and Laparoscopic Neurofunctional Pelvic Surgery

St. Elisabeth Hospital - Training Center of the ISPS

Werthmannstraße 1

50935 Cologne

Germany

Phone: +49/221/4677/13 01

Fax: +49/221/4677/13 09

Email: Marc.Possover@hohenlind.de

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