Anatomy of the Sacral Roots and the Pelvic Splanchnic Nerves in Women Using the LANN Technique
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Laparoscopic neuro-navigation identified and differentiated sacral nerve roots and pelvic splanchnic nerves, including vesical and rectal fibers, in women undergoing pelvic surgery without complication.
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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.
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References (7)
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- Nerve-Sparing Routes in Radical Pelvic Surgery 2018
- Laparoscopic Neuronavigation for Deep Lateral Pelvic Endometriosis: Clinical and Surgical Implications 2018
- Laparoscopic evaluation of female pelvic neuroanatomy and autonomic plexuses in terms of gynecologic perspective 2018
- Endometriosis Involving the Sciatic Nerve: A Case Report of Isolated Endometriosis of the Sciatic Nerve and Review of the Literature 2018
- Sciatic Nerve Involvement as an Unusual Presentation of Deep Endometriosis 2017
- Neuromodulation for the Treatment of Endometriosis-Related Symptoms 2016
- Laparoscopic anatomy of the autonomic nerves of the pelvis and the concept of nerve-sparing surgery by direct visualization of autonomic nerve bundles 2015
- Surgical Therapy of Endometriosis: Challenges and Controversies 2013
- Sacral Nerve Infiltrative Endometriosis Presenting as Perimenstrual Right-sided Sciatica and Bladder Atonia: Case Report and Description of Surgical Technique 2012
- Laparoscopic Therapy of Endometriosis and Vascular Entrapment of Sacral Plexus 2011
- Laparoscopic therapy for endometriosis and vascular entrapment of sacral plexus 2010
- Laparoscopic Management of Endopelvic Etiologies of Pudendal Pain in 134 Consecutive Patients 2009
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