Marc Possover1, Vito Chiantera, Jan Baekelandt. 1. Department of Obstetrics and Gynecology, St Elisabeth Hospital, Werthmannstrasse 1, Cologne, Germany. MarcPossover@aol.com
Abstract
AIMS: To report on our anatomic and electrophysiologic findings about the sacral nerve roots and the pelvic splanchnic nerves during laparoscopic pelvic surgery. METHODS: The pelvic splanchnic nerves and the sacral nerve roots were dissected in 336 consecutive patients undergoing laparoscopy for pelvic pain syndrome or gynecologic diseases. Intraoperative assessment of the functionality of the exposed nerves was performed using the LAparoscopic Neuro-Navigation (LANN) technique. RESULTS: Dissection of the sacral roots and the splanchnic pelvic nerves lateral to the sacral hypogastric fascia was feasible without any complications in all patients in this series. The mean surgical time was 16 minutes per side. The pelvic splanchnic nerves could be divided anatomically and functionally into vesical and rectal nerve fibers. CONCLUSIONS: Laparoscopy in combination with the LANN technique not only permits an intraoperative functional mapping of the pelvic motoric autonomous nerves but also a differentiation between the vesical and rectal nerves and between the efferent and afferent pelvic nerves.
AIMS: To report on our anatomic and electrophysiologic findings about the sacral nerve roots and the pelvic splanchnic nerves during laparoscopic pelvic surgery. METHODS: The pelvic splanchnic nerves and the sacral nerve roots were dissected in 336 consecutive patients undergoing laparoscopy for pelvic pain syndrome or gynecologic diseases. Intraoperative assessment of the functionality of the exposed nerves was performed using the LAparoscopic Neuro-Navigation (LANN) technique. RESULTS: Dissection of the sacral roots and the splanchnic pelvic nerves lateral to the sacral hypogastric fascia was feasible without any complications in all patients in this series. The mean surgical time was 16 minutes per side. The pelvic splanchnic nerves could be divided anatomically and functionally into vesical and rectal nerve fibers. CONCLUSIONS: Laparoscopy in combination with the LANN technique not only permits an intraoperative functional mapping of the pelvic motoric autonomous nerves but also a differentiation between the vesical and rectal nerves and between the efferent and afferent pelvic nerves.
Authors: Benoit Rabischong; Demetrio Larraín; Pierre Rabischong; Revaz Botchorishvili; Georges Fraisse; Stephane Gallego; Philippe Gaydier; Jean Michel Chardigny; Paul Avan Journal: Surg Endosc Date: 2011-06-03 Impact factor: 4.584
Authors: Wendy Yen Xian Peh; Roshini Mogan; Xin Yuan Thow; Soo Min Chua; Astrid Rusly; Nitish V Thakor; Shih-Cheng Yen Journal: Front Neurosci Date: 2018-03-21 Impact factor: 4.677
Authors: Tal D Saar; Stefaan Pacquée; Dean Helmar Conrad; Mikhail Sarofim; Philippe De Rosnay; David Rosen; Greg Cario; Danny Chou Journal: Gynecol Minim Invasive Ther Date: 2018-05-02