Concurrent primary repair of obturator nerve transection during pelvic lymphadenectomy procedure via laparoscopical approach

摘要

Introduction Obturator nerve is barely injured during gynecological surgeries. The risk for obturator nerve injury is increased during pelvic lymphadenectomy procedures of gynecological malignancies. In case of any obturator nerve injury, surgical management involve laparoscopic approaches suchas end-to-end anastomosis in very early period. Case A 63-year-old woman, with G3P3, presented with the complaint of abnormal uterine bleeding. She was diagnosed with stage IA endometrial adenocarcinoma. obturator nerve was transected during obturator lymph node dissection in the right side during retroperitoneal lymph node dissection. Subsequently end-to-end anastomosis of the thermally injured areas was performed by epineural sutures. Any significant loss of functions in adductor muscle wasn't observed in the postoperative period. Likewise, any permanent neurological finding wasn't developed at the end of postoperative 6th month. Discussion During pelvic lymphadenectomy; obturatory nerve, especially the proximal part, should be concerned. Early intraoperative repair should be performed in case of possible nerve injuries. Conclusion Immediate laparoscopic repair is possible in full-thickness injury of obturator nerve, occurred in a gynecological surgery and results with rapid and complete neurological recovery.