Laparoscopic obturator nerve neurolysis after pelvic lymphadenectomy

Postoperative neuropathy is a known complication of major pelvic oncologic surgery. Obturator nerve injury complicating pelvic lymph node dissection has been reported in the literature. Severity and duration of symptoms are determined by the severity of the initial nerve lesion. Different management options have been described in the literature. We report here on a patient who developed right obturator neuropathy after pelvic lymphadenectomy. Initial management by physical therapy was unsuccessful, and the patient underwent a successful laparoscopic surgical neurolysis. Whereas preventive measures remain essential to avoid any nerve injury, this case illustrates the use of laparoscopy to perform neurolysis with a favorable outcome; therefore, persistent pain or motor loss should motivate at least surgical exploration that can be done with low morbidity by laparoscopy.