• M Possover, J Baekelandt, C Flaskamp, D Li, and V Chiantera.
• Department of Obstetrics and Gynecology, St. Elisabeth Hospital, Cologne, Germany. Marc.Possover@hohenlind.de
• Minim Invas Neurosur. 2007 Feb 1;50(1):33-6.

BackgroundThe aim of this study is to report on the feasibility of laparoscopic neurolysis of the plexus sacralis and the sciatic nerve in deep endometriotic infiltration of the lateral pelvic wall.MethodsA transperitoneal approach to the pelvic nerves combined with the LANN technique for intraoperative assessment of the function of the exposed nerves permit exposure and sparing of all somatic nerves during resection of the endometriotic lesion.ResultsWe report on our short experience with 21 patients who underwent this technique for the treatment of endometriotic infiltration of the sacral plexus at different levels.ConclusionIn young patients with chronic unilateral sciatica or unilateral pudendal neuralgia - Alcock's canal syndrome - where no neurological/orthopedic etiologies have been found, endometriotic infiltration of the lateral pelvic wall has to be implicated as a potential etiology and an indication for laparoscopy must be discussed. Laparoscopic neurolysis of the pelvic somatic nerves is a feasible procedure for trained laparoscopic surgeons who have a good knowledge of the retroperitoneal pelvic (neuro)anatomy.

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