title: Technical feasibility of robot-assisted minimally-invasive neurolysis of the lateral cutaneous nerve of thigh: About a case.
abstract: To limit the risk of iatrogenic neuroma and recurrence after surgical treatment of meralgia paresthetica, some authors have recently developed a technique of endoscopic neurolysis of the lateral cutaneous nerve of thigh (LCNT) below the level of the inguinal ligament. We report the case of a robot-assisted endoscopic technique underneath the inguinal ligament. A 62-year-old patient suffering of idiopathic meralgia paresthetica for the past 18 months received a Da Vinci robot-assisted minimally-invasive 10cm long neurolysis, of which 1/3 was situated above the level of the inguinal ligament and 2/3 below it. The patient was discharged the following day without complications. At 6-months follow-up the pain was rated 0/10 compared to 5/10 pre-operatively. Robot-assisted endoscopic neurolysis of the LCNT retains the advantages of conventional endoscopy and enables to approach the nerve in the most frequently compressed zone underneath the inguinal ligament. The three-dimensional view offered by robotic surgery facilitates the dissection. The superiority of this technique remains to be demonstrated by comparing it to conventional techniques.
authors.affiliation: Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, FMTS, University of Strasbourg, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
authors.forename: A
authors.initials: A
authors.lastname: Bruyere
authors.affiliation: Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, FMTS, University of Strasbourg, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
authors.forename: J J
authors.initials: JJ
authors.lastname: Hidalgo Diaz
authors.affiliation: Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, FMTS, University of Strasbourg, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
authors.forename: P
authors.initials: P
authors.lastname: Vernet
authors.affiliation: Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, FMTS, University of Strasbourg, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
authors.forename: S
authors.initials: S
authors.lastname: Salazar Botero
authors.affiliation: Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, FMTS, University of Strasbourg, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
authors.forename: S
authors.initials: S
authors.lastname: Facca
authors.affiliation: Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, FMTS, University of Strasbourg, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France. Electronic address: Philippe.liverneaux@chru-strasbourg.fr.
authors.forename: P-A
authors.initials: PA
authors.lastname: Liverneaux
mesh_terms: D004210:Dissection / Q000379:methods*; D020428:Femoral Neuropathy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000601:surgery*; D009463:Neuroma / Q000517:prevention & control; D010525:Peripheral Nerves / Q000601:surgery*; D065287:Robotic Surgical Procedures; D013848:Thigh / Q000294:innervation
keywords: Chirurgie mini-invasive; Da Vinci robot; Lateral cutaneous nerve of thigh; Meralgia paresthetica; Minimally-invasive surgery; Méralgie paresthésique; Nerf cutané latéral de la cuisse; Neurapraxia; Neurapraxie; Neurectomie; Neurectomy; Neurolyse; Neurolysis; Robot Da Vinci