Possover Marc, Chiantera Vito, Baekelandt Jan
Department of Obstetrics and Gynecology, St Elisabeth Hospital, Werthmannstrasse 1, Cologne, Germany.
Surg Laparosc Endosc Percutan Tech. 2007 Dec;17(6):508-10. doi: 10.1097/SLE.0b013e31812f81e4.
To report on our anatomic and electrophysiologic findings about the sacral nerve roots and the pelvic splanchnic nerves during laparoscopic pelvic surgery.
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.
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.
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.
报告我们在腹腔镜盆腔手术中关于骶神经根和盆内脏神经的解剖及电生理发现。
对336例因盆腔疼痛综合征或妇科疾病接受腹腔镜检查的连续患者进行盆内脏神经和骶神经根的解剖。使用腹腔镜神经导航（LANN）技术对暴露神经的功能进行术中评估。
在本系列所有患者中，在骶骨下腹筋膜外侧解剖骶神经根和盆内脏神经是可行的，且无任何并发症。平均手术时间为每侧16分钟。盆内脏神经在解剖和功能上可分为膀胱神经纤维和直肠神经纤维。
腹腔镜检查结合LANN技术不仅能在术中对盆腔运动自主神经进行功能定位，还能区分膀胱神经和直肠神经以及盆部传出神经和传入神经。
