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511 Obturative nerve complication in laparoscopic treatment of endometrial cancer
  1. E Milnerowicz-Nabzdyk,
  2. M Kalus,
  3. K Nowak,
  4. J Tomiczek-Szwiec,
  5. M Mrugała and
  6. A Machnicka-Rusek
  1. SPZOZ Opolskie Centrum Onkologii im. prof. Tadeusza Koszarowskiego, Opole, Poland


Introduction/Background*Intraoperative, iatrogenic demage of periferal nerves are rare but serious operative complication. Miss it or incorect repair can get serious consequences for patient. During laparoscopic pelvic lymphadenectomy, specialy when we remove metastases from obturatory fossa, the risk of demage obturator nerve is considerable. Very importent is correct intraoperative diagnosis of those complication and the knowlege of repair techics.

Methodology The aim of reconstruction of demaging obturator nerve is to restore the apropriate function. That’s the motoric nerve responsible for adduction and walking. Subtile disfunction of a sensation are possible as well.

Result(s)*54 years old women with clarocellular endometrial cancer with Massive infiltration of cervix, was admitted to Oncological Center for surgical treatment. She was previously hospitalized in Oncosurgery department due to isolating chanage in paraaortic lymphnodes. The enlarged nodous were removed . In H-P the suspicious of the endometrial cencer as primary focus were given. In CT and MRI examinations the selective pathology of lymphnodes of the left pelvic side were detected. The radical hysterectomy type B with selective lymphadenectomy of the left side were done. During dissection of oburative space the iatrogenic damage of the obturative nerve were detected. The preparation of whole obturative nerve were performed end to end anastomosis with 6.0 monofilament suture was made. The surgery were continued due to qualification. In postoperative observation the patient didn’t claimed any mobile disfunction of the left leg. In neurological examination discreet symptoms of disfunction could be observed, which subside in a few weeks.

Conclusion*Described case proves that laparoscopical technique has the benefits not only in minimally invasive treatment of endometrial cancer but in neural complications as well what could be much more difficult in traditional laparotomical route.

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