Open Access Case report

Laparoscopic injury of the obturator nerve during fertility-sparing procedure for cervical cancer

Enzo Ricciardi1*, Marina Jakimovska2, Paolo Maniglio1, Mauro Schimberni1, Antonio Frega1, Borut Kobal2 and Massimo Moscarini1

Author Affiliations

1 Department of Obstetrics and Gynecology, Sapienza University of Rome. Sant’Andrea Hospital, via di Grottarossa, 1035-1039, Rome, 00189, Italy

2 Department of Obstetrics and Gynecology University Medical Center, Ljubljana, Slovenia

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World Journal of Surgical Oncology 2012, 10:177 doi:10.1186/1477-7819-10-177

Published: 30 August 2012

Abstract

Background

Intraoperative injury of the obturator nerve has rarely been reported in patients with gynecological malignancies undergoing extensive radical surgeries. Irreversible damage of this nerve causes thigh paresthesia and claudication. Intraoperative repair may be done by end-to-end anastomosis or grafting when achieving tension-free anastomosis is not possible.

Case presentation

A 28-year-old woman with stage IB cervical cancer underwent fertility–sparing surgery, including conization and bilateral pelvic lymphadenectomy. The left obturator nerve was damaged intraoperatively during pelvic dissection.

Conclusion

Immediate laparoscopic repair was successful and there was no functional deficit in the left thigh for six months postoperatively.

Keywords:
Cervical cancer; Fertility-sparing procedure; Laparoscopy; Lymphadenectomy; Obturator nerve injury