title: Successful obturator nerve repairing: Intraoperative sural nerve graft harvesting in endometrium cancer patient.
abstract: BACKGROUND
  Intraoperative injury of obturator nerve is a rare complication of gynecologic surgeries, it has been reported especially in patients with endometriosis and genitourinary malignancies. Gynecologic patients undergoing open lymphadenectomy are at increased risk of obturator nerve injury.
  
  
  METHODS
  A 60-year-old woman with FIGO stage II Grade II endometrial adenocarcinoma underwent bilateral pelvic paraaortic lymphadenectomy. During right obturator lymph node dissection, the right obturator nerve was inadvertently transected with Harmonic scalpel sealing system. The graft was used to anastomose epyneurium of distal segment of obturator nerve to its counterpart in the proximal segment with 10-0 prolen suture.
  
  
  CONCLUSIONS
  In case of iatrogenic nerve transection, microsurgical end to end tension-free coaptation is advocated. In case of the obturator nerve is fixed and because of the thermal injury end to end alignment can not be achieved, nerve grafting is necessary.
  
  
  CONCLUSIONS
  According to our knowledge, successful immediate grafting of iatrogenically damaged obturator nerve during pelvic lymphadenectomy in our patient is the third report of such a case, but also it has a unique feature of being the first obturator nerve repairing case after dissected with tissue sealing system which causes large sealed area that does not make it possible to make end-to-end anastomosis without nerve harvesting.
authors.affiliation: Department of Gynecology and Obstetrics, Bulent Ecevit University, Zonguldak, Turkey.
authors.forename: Müge
authors.initials: M
authors.lastname: Harma
authors.affiliation: Department of Gynecology and Obstetrics, Bulent Ecevit University, Zonguldak, Turkey. Electronic address: gorkersel@yandex.com.
authors.forename: Görker
authors.initials: G
authors.lastname: Sel
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey.
authors.forename: Bektaş
authors.initials: B
authors.lastname: Açıkgöz
authors.affiliation: Department of Gynecology and Obstetrics, Bulent Ecevit University, Zonguldak, Turkey.
authors.forename: Mehmet İbrahim
authors.initials: Mİ
authors.lastname: Harma
keywords: Endometrium cancer; Harmonic scalpel; Nerve graft; Obturator nerve; Thermal nerve injury