From the Division of Gynecologic Oncology and the Department of Obstetrics and Gynecology, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, New York; and the Department of Obstetrics and Gynecology, Winthrop University Hospital, Mineola, New York.
Obstet Gynecol. 2012 Feb;119(2 Pt 2):462-464. doi: 10.1097/AOG.0b013e31823d0c4f.
Obturator nerve injury may occur in gynecologic surgery, particularly in cases in which extensive pelvic sidewall retroperitoneal dissection is performed. The lack of tactile feedback from the robotic surgical system may contribute to obturator nerve injury. If surgical division occurs, microsurgical end-to-end anastomosis of the obturator nerve may be performed.
A 76-year-old woman with stage IA endometrial adenocarcinoma sustained a left obturator nerve transection during pelvic lymphadenectomy that was recognized immediately. Robotic-assisted laparoscopic repair was performed successfully, with the patient experiencing no residual neuropathy 6 months postoperatively.
Robotic-assisted laparoscopic repair is feasible for the treatment of obturator nerve injury.
闭孔神经损伤可能发生在妇科手术中，特别是在广泛进行骨盆侧壁后腹膜解剖时。机器人手术系统缺乏触觉反馈可能导致闭孔神经损伤。如果发生手术分离，可进行闭孔神经的显微外科端端吻合术。
一名 76 岁患有 IA 期子宫内膜腺癌的女性在行盆腔淋巴结清扫术时发生左侧闭孔神经切断，术中即刻发现。成功进行了机器人辅助腹腔镜修复，术后 6 个月患者无残留神经病变。
机器人辅助腹腔镜修复术是治疗闭孔神经损伤的可行方法。
