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750 Obturator nerve repair in a patient with endometrial cancer
  1. Selcuk Erkilinc1,
  2. Ilker Cakir1,
  3. Ayse Betul Ozturk2 and
  4. Sena Ozcan2
  1. 1Izmir Democracy University Buca Seyfi Demirsoy Education and Research Hospital, Izmir, Turkey
  2. 2Health Sciences University Izmir Tepecik Education and Research Hospital, Izmir, Turkey


Introduction/Background Laparoscopic surgery is a worldwide used technique for endometrial cancer surgery. Complications associated with the surgery include bleeding and conversion to laparotomy. Obturator nerve injury is a complication of pelvic lymphadenectomy. Herein, we aim to report the repair of obturator nerve injury in an endometrial cancer patient.

A 35-year-old woman, gravida: 4, parity: 4, was admitted to our hospital with abnormal uterine bleeding. Endometrial biopsy revealed endometrioid adenocarcinoma grade 2. Ultrasonographic imaging showed a 3 cm endometrial tumor. No distant metastasis was seen on CT and MRI images. Laparoscopic hysterectomy and pelvic lymphadenectomy were planned.

Methodology The surgery was initiated with pelvic lymphadenectomy. During left pelvic lymphadenectomy, obturator vein injury occurred. A suction catheter was used to remove bleeding; however, due to impaired vision, obturator nerve injury occurred during hemostasis in the avascular space between the external iliac artery and the psoas muscle. The cut ends of obturator nerves were found. The tension was high when the cut ends were brought together. The nerve was freed from neighboring tissues. 3–0 Vicryl suture was used for suturing, and 4 interrupted sutures were applied.

Results The patient complained of left thigh pain after surgery. Analgesia was given to reduce the pain. Physical therapy was prescribed for the patient. The patient was able to perform adduction with limited restriction.

Conclusion Obturator nerve injury is one of the complications of endometrial cancer surgery. Conversion to laparotomy is not needed for the repair. Laparoscopic obturator nerve injury repair has favorable outcomes even in the early postoperative period.

Disclosures In the current video, we present the repair of obturator nerve injury in an endometrial cancer patient.

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