The LANN Technique to Reduce Postoperative Functional Morbidity in Laparoscopic Radical Pelvic Surgery

Marc Possover, Possover M, Jens Quakernack, Quakernack J, Vito Chiantera, Vito Chiàntera
Journal of the American College of Surgeons · 2005 · vol. 201(6) , pp. 913–917 · doi:10.1016/j.jamcollsurg.2005.07.006 · PMID:16310695 · W2062570303
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-09 ⓘ

Laparoscopic Neuro-Navigation was used to spare pelvic parasympathetic nerves during radical pelvic surgery in 261 patients, resulting in a less than 1% rate of postoperative bladder dysfunction.

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This prospective pilot study evaluated the feasibility of Laparoscopic Neuro-Navigation (LANN) in 261 patients undergoing radical pelvic surgery for cervical cancer or deep infiltrating endometriosis. The researchers utilized dissection and electrostimulation to spare pelvic parasympathetic nerves during parametrial transection, subsequently documenting postoperative bladder function. The results demonstrated that this nerve-sparing approach was feasible without complications and reduced the incidence of postoperative bladder dysfunction to less than one percent. Relevance to endometriosis: Listed as an indication for laparoscopic radical pelvic surgery, specifically addressing deep infiltrating endometriosis of the parametria.

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Abstract

BACKGROUND: We investigated the feasibility and advantages of introducing Laparoscopic Neuro-Navigation (LANN) into the field of laparoscopic gynecologic radical pelvic surgery. STUDY DESIGN: In a prospective pilot study, 261 consecutive patients underwent laparoscopic radical pelvic surgery for cervical cancer or deep infiltrating endometriosis of the parametria. During the procedure, dissection and electrostimulation, and consequently, sparing of the pelvic parasympathetic nerves by transection of the parametria, were performed. Postoperative bladder dysfunction was documented. RESULTS: Laparoscopic dissection and electrostimulation of the pelvic splanchnic nerves were feasible in all patients without any complications, and the rate of postoperative bladder dysfunction was considerably reduced, to less than 1% of the patients. CONCLUSIONS: The parasympathetic nerve-sparing method using the Laparoscopic Neuro-Navigation technique in laparoscopic radical pelvic gynecologic surgery is a feasible and reproducible technique that preserves postoperative bladder function.
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Background

We investigated the feasibility and advantages of introducing Laparoscopic Neuro-Navigation (LANN) into the field of laparoscopic gynecologic radical pelvic surgery. STUDY DESIGN: In a prospective pilot study, 261 consecutive patients underwent laparoscopic radical pelvic surgery for cervical cancer or deep infiltrating endometriosis of the parametria. During the procedure, dissection and electrostimulation, and consequently, sparing of the pelvic parasympathetic nerves by transection of the parametria, were performed. Postoperative bladder dysfunction was documented.

Results

Laparoscopic dissection and electrostimulation of the pelvic splanchnic nerves were feasible in all patients without any complications, and the rate of postoperative bladder dysfunction was considerably reduced, to less than 1% of the patients.

Conclusions

The parasympathetic nerve-sparing method using the Laparoscopic Neuro-Navigation technique in laparoscopic radical pelvic gynecologic surgery is a feasible and reproducible technique that preserves postoperative bladder function.

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Condition tags

endometriosisdie_deep_infiltrating

MeSH descriptors

Endometriosis Hysterectomy, Vaginal Laparoscopy Rectal Diseases Vaginal Diseases Adult Aged Endometriosis Feasibility Studies Female Humans Hysterectomy, Vaginal Laparoscopy Middle Aged Pilot Projects Postoperative Period Prospective Studies Rectal Diseases Splanchnic Nerves Splanchnic Nerves

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