Robotic-Assisted Laparoscopic Transection and Repair of an Obturator Nerve During Pelvic Lymphadenectomy for Endometrial Cancer

BACKGROUND: Obturator nerve injury may occur in gynecologic surgery, particularly in cases in which extensive pelvic sidewall retroperitoneal dissection is performed. The lack of tactile feedback from the robotic surgical system may contribute to obturator nerve injury. If surgical division occurs, microsurgical end-to-end anastomosis of the obturator nerve may be performed. CASE: A 76-year-old woman with stage IA endometrial adenocarcinoma sustained a left obturator nerve transection during pelvic lymphadenectomy that was recognized immediately. Robotic-assisted laparoscopic repair was performed successfully, with the patient experiencing no residual neuropathy 6 months postoperatively. CONCLUSION: Robotic-assisted laparoscopic repair is feasible for the treatment of obturator nerve injury. (Obstet Gynecol 2012;119:462-4) DOI: 10.1097/AOG.0b013e31823d0c4f