Robot‐assisted laparoscopic management of a vascular entrapment of the sacral nerve roots causing pelvic pain

Abstract

The aim of this case report is to demonstrate the robot-assisted laparoscopic decompression approach to treat the aberrant vessels entrapping the sacral nerves causing pelvic pain. A 34-year-old female patient had been complaining about pelvic pain on the left perineal region which was radiating to the sacral 1-2 nerves dermatome for 3 years. Decompression of sacral nerve roots and sciatic nerve was performed via robotassisted and a four-arm Da Vinci Si Surgical System laparoscopic approach. This case report is the first presentation of robot-assisted laparoscopic management of a vascular entrapment of the sacral nerve roots. The robotic technique offers, three-dimensional vision, improved maneuverability and enhanced ergonomics in the deepest area in the pelvis and could be a valid alternative to laparoscopy in the treatment of intrapelvic neurovascular entrapments.

Laparoscopic approach to refractory extraspinal sciatica and pudendal pain caused by intrapelvic nerve entrapment

“…In our patients, the failure rate of LANN decompression was 86% higher when surgery was performed more than 2 years from symptom onset. Although this difference in failure rate did not reach statistical significance, likely due to our limited sample size, it is consistent with the current literature, meaning this likely reflects a reality 4 , 15 , 19 – 21 .…”

“…The LANN technique was later proposed as a minimally invasive detrapment method to significantly reduce or completely resolve pain secondary to INEs. This surgical intervention follows the same principles of surgeries that have been successfully used in the treatment of other peripheral nerve entrapment syndromes 9 , 14 , 15 .…”