EP570 Obturator nerve section during laparoscopic pelvic lymphadenectomy, what to do?

2019 
Introduction/Background The injury of the obturator nerve during pelvic oncologic surgery can be a stressful and unexpected complication during otherwise successful surgery. Injuries of obturator nerve can produce numbness or pain of the inner thigh or groin and weakened adduction of the thigh. The immediate repair of a freshly transected nerve can be done successfully, with good postoperative results. Methodology We present a case of patient with an endometrial cancer who suffered an obturator nerve section during laparoscopic comprehensive surgical staging surgery. Results The patient was a 57 year old women with a serous carcinoma of the endometrium who underwent comprehensive staging surgery. During the dissection of right pelvic lymphadenectomy, the obturator nerve was unintentionally sectioned at the level of the common iliac artery bifurcation. The defect was repaired by end-to-end suture with 5-0 prolene and tissucol sealant was added to reinforce de union. The patient did not developed any functional deficiency and the neurophysiological study performed after showed a complete recovery of the nerve. Conclusion Immediate repair of the obturator nerve by laparoscopic suture is a good solution with good postoperative results, in cases of nerve section during laparoscopic pelvic lymphadenectomy. Disclosure Nothing to disclose.
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