Laparoscopic repair of obturator nerve injury during pelvic lymphadenectomy: a case report
- Obstetrics & Gynecology International Journal
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Yoshitaka Kaido, Nanako Jonai, Minami Oshikiri, Kazuyuki Murakami, Sho Sato, Eriko Takatori, Hiroki Onoue, Takayuki Nagasawa, Masahiro Kagabu, Tadahiro Shoji, Tsukasa Baba
Abstract
Obturator nerve injury is a rare complication of pelvic lymphadenectomy in gynecologic oncology. We report a case of intraoperative obturator nerve transection and its successful laparoscopic repair. A 73-year-old woman with stage IB1 cervical cancer underwent laparoscopic radical hysterectomy with pelvic lymphadenectomy. The right obturator nerve was inadvertently transected but successfully repaired laparoscopically using 4-0 polyglactin sutures. Postoperatively, she had mild thigh adduction weakness but recovered nearly fully within three months. At 45 months, she remained recurrence-free with no neurological sequelae. Careful nerve identification is crucial during lymphadenectomy to prevent injury. If transection occurs, immediate laparoscopic repair with tension-free and end-to-end suturing is feasible and effective, ensuring favorable functional outcomes.
Keywords
obturator nerve injury, laparoscopic repair, pelvic lymphadenectomy, gynecologic oncology, nerve anastomosis