The LANN technique to reduce postoperative functional morbidity in laparoscopic radical pelvic surgery.
BACKGROUND
We investigated the feasibility and advantages of introducing Laparoscopic Neuro-Navigation (LANN) into the field of laparoscopic gynecologic radical pelvic surgery.


METHODS
In a prospective pilot study, 261 consecutive patients underwent laparoscopic radical pelvic surgery for cervical cancer or deep infiltrating endometriosis of the parametria. During the procedure, dissection and electrostimulation, and consequently, sparing of the pelvic parasympathetic nerves by transection of the parametria, were performed. Postoperative bladder dysfunction was documented.


RESULTS
Laparoscopic dissection and electrostimulation of the pelvic splanchnic nerves were feasible in all patients without any complications, and the rate of postoperative bladder dysfunction was considerably reduced, to less than 1% of the patients.


CONCLUSIONS
The parasympathetic nerve-sparing method using the Laparoscopic Neuro-Navigation technique in laparoscopic radical pelvic gynecologic surgery is a feasible and reproducible technique that preserves postoperative bladder function.
Possover
Marc
M
Department of Obstetrics and Gynecology, St Elisabeth-Hospital, Cologne, Germany.
Quakernack
Jens
J
Chiantera
Vito
V
D000328:Adult; D000368:Aged; D004715:Endometriosis / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D010865:Pilot Projects; D011184:Postoperative Period; D011446:Prospective Studies; D012002:Rectal Diseases / Q000601:surgery*; D013153:Splanchnic Nerves / Q000033:anatomy & histology; D002583:Uterine Cervical Neoplasms / Q000601:surgery; D014623:Vaginal Diseases / Q000601:surgery*