Laparoscopic Excision of Obturator Nerve Schwannoma

Video Objective Obturator nerve schwannomas are extremely rare with only 11 cases being reported in the English-language literature. The pre-operative diagnosis is difficult due to non-specific symptoms and atypical imaging findings. The excision of an obturator nerve schwannoma is a challenging task because of the narrow obturator fossa which is surrounded by vital structures and it is important to preserve the nerve to prevent any post-operative neurological disorders Setting A 42 year old married lady presented to us with complaints of pain in the left leg for the past 4 years. The examination was unremarkable and MRI pelvis revealed a 6.1 × 6.3cm encapsulated retroperitoneal mass on left side with septations and cystic changes and it was displacing the internal iliac vessels medially. Interventions With the help of laparoscopy, we could achieve a magnified view of the pelvic anatomy and meticulous dissection could be done to enucleate the tumor and preserve the integrity of obturator nerve. The operative time was 40 minutes and there was no blood loss. The post-operative course was uneventful and the patient was discharged after 4 days. On follow-up, the patient did not have any neurological deficits and no bowel, bladder complaints. Conclusion Thus, laparoscopic surgery can be done with basic knowledge of surgical anatomy of pelvis and it helps in preserving the nerve function and faster recovery.