Laparoscopic Excision of Obturator Nerve Endometriosis: A Stepwise Approach
Sanah Alani1, Dong Bach Nguyen1, Jessica Papillon Smith1
1Department of Obstetrics & Gynecology, McGill University Health Centre, Montreal, Quebec, Canada (all authors).
Objective:
To demonstrate a reproducible approach to the laparoscopic excision of endometriosis involving the obturator nerve.
Setting:
Academic tertiary care hospital.
Participants:
Case of a 30-year-old woman found on MRI to have a 1.6 cm endometriosis nodule involving the left obturator nerve, along with adenomyosis, rectovaginal, and ureteric endometriosis. Due to symptoms refractory to medical management, a laparoscopy is performed to excise the obturator nerve lesion, in addition to a disc rectal excision and ureteral reimplantation.
Interventions:
Laparoscopic excision of obturator nerve endometriosis.
Conclusion:
Excision of obturator nerve endometriosis by laparoscopy can be safely performed with a thorough knowledge of anatomy and a systematic dissection of pelvic spaces. MRI is essential for preoperative planning in these rare forms of deep infiltrating endometriosis. VIDEO ABSTRACT.
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