| Autor: |
Bozzetti, J, Santos, GC, Fernandes, GL, Mattos, LA, Ayroza, P, Salomão, H |
| Zdroj: |
Journal of Minimally Invasive Gynecology; 2024 Supplement, Vol. 31 Issue 11, pS52-S52, 1p |
| Abstrakt: |
To report a case of endometriosis of the sciatic nerve successfully treated with videolaparoscopy. Video article of excision of endometriosis of the sciatic nerve. Patient in supine decubitus with legs in a semi lithotomy position, under general anesthesia. Female, 35 years old, complaining of cyclic right gluteal pain for a year. A MRI was performed and revealed an endometriotic nodule measuring 3 cm involving the right sciatic nerve, the sacral roots and infiltrating the periosteum, obturator and elevator ani muscles, with no other signs of endometriosis in the pelvis. The proposed treatment was excision of the endometriotic nodule in the sciatic nerve with a lateral approach, which consists in the opening of the iliolumbar fossa between the external iliac vessels and the psoas muscle, followed by the identification of the main neural structures in this location: obturator nerve, pudendal nerve, lumbosacral trunk, sacral roots and the emergence of the sciatic nerve. The complete removal of the nodule was achieved with an alternating approach to all limits of the nodule previously identified, with subsequent release of the sciatic nerve. The integrity of the nerve and other main structures was fully preserved. The patient underwent postoperative intensive physiotherapy and pain treatment with pregabalin starting the day after surgery and ultimately had a full recovery. The sciatic nerve endometriosis is a challenging disease for gynecologists which demands thorough knowledge of the pelvic anatomy in order to achieve success and avoid complications. [ABSTRACT FROM AUTHOR] |
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