title: Laparoscopic management of obturator nerve schwannomas:  experiences with 6 cases and review of the literature.
abstract: OBJECTIVE
  To present our experiences in management of obturator nerve schwannomas by laparoscopy.
  
  
  METHODS
  Six patients who were diagnosed preoperatively with pelvic tumors and histologically with obturator nerve schwannomas were treated by laparoscopy in our hospital between 1998 and 2009. Clinical data were obtained by a retrospective review of all the patients' medical records, radiologic reports, pathologic reports, and operation videos.
  
  
  RESULTS
  A total of 6 tumors were found in 6 patients, none of which was correctly, preoperatively diagnosed as a schwannoma. In 5 of them, obturator nerve roots were identified to be associated with the tumors during the operation. All of the tumors were resected successfully by laparoscopy, including 2 resected by enucleation. Postoperatively, 2 patients developed a permanent neurological deficit, 2 patients developed transient nerve neuropathy but complete resolution within 8 weeks, and the other 2 developed no neurological deficit. Pathologic examination showed that all the tumors were benign schwannoma. At a mean follow-up of 24 months (range, 12 to 48 mo) postresection, all the patients remained free from recurrence.
  
  
  CONCLUSIONS
  Pelvic schwannomas are rare and difficult to diagnose preoperatively. The intraoperative observation of the nerve running through the tumor may aid the diagnosis. Although obturator nerve injury does not seem to be associated with severe impairments, efforts should be made to preserve the integrity of the nerve. Laparoscopic surgery is a safe and feasible method for approaching benign schwannoma in the obturator fossa.
authors.affiliation: Department of Urology, Lihuili Hospital, Ningbo Medical Center, Affiliated Hospital of Medical School of Ningbo University, Ningbo, China. linningshu@163.com
authors.forename: Lin
authors.initials: L
authors.lastname: Ningshu
authors.forename: Yin
authors.initials: Y
authors.lastname: Min
authors.forename: Yang
authors.initials: Y
authors.lastname: Xieqiao
authors.forename: Yang
authors.initials: Y
authors.lastname: Yuanqing
authors.forename: Mao
authors.initials: M
authors.lastname: Xiaoqiang
authors.forename: Li
authors.initials: L
authors.lastname: Rubing
mesh_terms: D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000601:surgery*; D009776:Obturator Nerve / Q000601:surgery*; D010386:Pelvic Neoplasms / Q000601:surgery*; D010524:Peripheral Nervous System Neoplasms / Q000601:surgery*; D012189:Retrospective Studies