Surgical Neuropelveology: Laparoscopic Nerve-sparing Excision of a Pelvic Schwannoma

Abstract

Study objective: To show how advanced pelvic Schwannoma can be safely managed with a laparoscopic approach.

Design: Demonstration of the laparoscopic technique with narrated video footage.

Setting: Schwannomas are benign tumors that arise from well-differentiated Schwann cells (glial cells) of peripheral nerve sheaths. Schwannomas are nonaggressive, slow-growing, solitary masses with a low rate of malignant transformation and a low risk of recurrence after resection. They rarely occur in the pelvis, with a reported incidence of 1% to 3%. Tumors involving spinal nerve roots commonly present with radicular pain and nerve compression syndromes (Supplemental Video 1-3). This video shows the management of pelvic Schwannoma originating from the left sacral root S1 by a minimally invasive approach.

Interventions: Laparoscopic nerve-sparing excision of a pelvic Schwannoma.

Conclusion: Historically, pelvic schwannomas have been managed mainly by laparotomy. Here, we demonstrate the feasibility and safety of a large pelvic Schwannoma excision by a minimally invasive approach.

Keywords: Laparoscopy; Nerve-sparing; Neuropelveology; Sacral plexus; Schwannoma.