Successful obturator nerve repairing: Intraoperative sural nerve graft harvesting in endometrium cancer patient

Introduction Intraoperative injury of obturator nerve is a rare complication of gynecologic surgeries, it has been reported especially in patients with endometriosis and genitourinary malignancies. Gynecologic patients undergoing open lymphadenectomy are at increased risk of obturator nerve injury. PRESENTATION OF CASE A 60-year-old woman with FIGO stage II Grade II endometrial adenocarcinoma underwent bilateral pelvic paraaortic lymphadenectomy. During right obturator lymph node dissection, the right obturator nerve was inadvertently transected with Harmonic scalpel sealing system. The graft was used to anastomose epyneurium of distal segment of obturator nerve to its counterpart in the proximal segment with 10-0 prolen suture. DISCUSSION In case of iatrogenic nerve transection, microsurgical end to end tension-free coaptation is advocated. In case of the obturator nerve is fixed and because of the thermal injury end to end alignment can not be achieved, nerve grafting is necessary. CONCLUSION According to our knowledge, successful immediate grafting of iatrogenically damaged obturator nerve during pelvic lymphadenectomy in our patient is the third report of such a case, but also it has a unique feature of being the first obturator nerve repairing case after dissected with tissue sealing system which causes large sealed area that does not make it possible to make end-to-end anastomosis without nerve harvesting. © 2014 Elsevier Ltd. All rights reserved.

Yazar Harma M.
Sel G.
Açikgöz B.
Harma M.I.
Yayın Türü Article
Tek Biçim Adres https://hdl.handle.net/20.500.12628/7689
Tek Biçim Adres 10.1016/j.ijscr.2014.03.028
Konu Başlıkları Endometrium cancer
Harmonic scalpel
Nerve graft
Obturator nerve
Thermal nerve injury
Koleksiyonlar Araştırma Çıktıları | WoS | Scopus | TR-Dizin | PubMed | SOBİAD
Scopus İndeksli Yayınlar Koleksiyonu
Dergi Adı International Journal of Surgery Case Reports
Dergi Cilt Bilgisi 5
Dergi Sayısı 6
Sayfalar 345 - 346
Yayın Yılı 2014
Eser Adı
[dc.title]
Successful obturator nerve repairing: Intraoperative sural nerve graft harvesting in endometrium cancer patient
Yazar
[dc.contributor.author]
Harma M.
Yazar
[dc.contributor.author]
Sel G.
Yazar
[dc.contributor.author]
Açikgöz B.
Yazar
[dc.contributor.author]
Harma M.I.
Yayın Yılı
[dc.date.issued]
2014
Yayıncı
[dc.publisher]
Elsevier Ltd
Yayın Türü
[dc.type]
article
Özet
[dc.description.abstract]
Introduction Intraoperative injury of obturator nerve is a rare complication of gynecologic surgeries, it has been reported especially in patients with endometriosis and genitourinary malignancies. Gynecologic patients undergoing open lymphadenectomy are at increased risk of obturator nerve injury. PRESENTATION OF CASE A 60-year-old woman with FIGO stage II Grade II endometrial adenocarcinoma underwent bilateral pelvic paraaortic lymphadenectomy. During right obturator lymph node dissection, the right obturator nerve was inadvertently transected with Harmonic scalpel sealing system. The graft was used to anastomose epyneurium of distal segment of obturator nerve to its counterpart in the proximal segment with 10-0 prolen suture. DISCUSSION In case of iatrogenic nerve transection, microsurgical end to end tension-free coaptation is advocated. In case of the obturator nerve is fixed and because of the thermal injury end to end alignment can not be achieved, nerve grafting is necessary. CONCLUSION According to our knowledge, successful immediate grafting of iatrogenically damaged obturator nerve during pelvic lymphadenectomy in our patient is the third report of such a case, but also it has a unique feature of being the first obturator nerve repairing case after dissected with tissue sealing system which causes large sealed area that does not make it possible to make end-to-end anastomosis without nerve harvesting. © 2014 Elsevier Ltd. All rights reserved.
Kayıt Giriş Tarihi
[dc.date.accessioned]
2019-12-23
Açık Erişim Tarihi
[dc.date.available]
2019-12-23
Yayın Dili
[dc.language.iso]
eng
Konu Başlıkları
[dc.subject]
Endometrium cancer
Konu Başlıkları
[dc.subject]
Harmonic scalpel
Konu Başlıkları
[dc.subject]
Nerve graft
Konu Başlıkları
[dc.subject]
Obturator nerve
Konu Başlıkları
[dc.subject]
Thermal nerve injury
Haklar
[dc.rights]
info:eu-repo/semantics/openAccess
ISSN
[dc.identifier.issn]
2210-2612
İlk Sayfa Sayısı
[dc.identifier.startpage]
345
Son Sayfa Sayısı
[dc.identifier.endpage]
346
Dergi Adı
[dc.relation.journal]
International Journal of Surgery Case Reports
Dergi Sayısı
[dc.identifier.issue]
6
Dergi Cilt Bilgisi
[dc.identifier.volume]
5
Tek Biçim Adres
[dc.identifier.uri]
https://dx.doi.org/10.1016/j.ijscr.2014.03.028
Tek Biçim Adres
[dc.identifier.uri]
https://hdl.handle.net/20.500.12628/7689
Görüntülenme Sayısı ( Şehir )
Görüntülenme Sayısı ( Ülke )
Görüntülenme Sayısı ( Zaman Dağılımı )
Görüntülenme
16
09.12.2022 tarihinden bu yana
İndirme
1
09.12.2022 tarihinden bu yana
Son Erişim Tarihi
07 Şubat 2024 23:07
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Tıklayınız
obturator lymphadenectomy injury grafting segment patients system pelvic sealing damaged during iatrogenically immediate patient successful knowledge According CONCLUSION necessary achieved alignment thermal because advocated Introduction report reserved rights Elsevier harvesting without anastomosis end-to-end possible sealed
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