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首页> 外文期刊>Surgical Endoscopy >Intra-abdominal laparoscopic pudendal canal decompression - a feasibility study.
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Intra-abdominal laparoscopic pudendal canal decompression - a feasibility study.

机译：腹腔镜下阴部管道减压-可行性研究。

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BACKGROUND: Pudendal canal syndrome (PCS) is induced by the compression or the stretching of the pudendal nerve within Alcock's canal. METHODS: Considering the difficulty and possible complications involved in exposing the pudendal canal and nerve by either transperineal, transgluteal or transischiorectal approaches, an intra-abdominal laparoscopic pudendal canal decompression (ILPCD) was employed. For this technique, 30 male adult human cadavers were examined. RESULTS: Measurements revealed an adequate working space in 16 (80%) of the 20 cadavers, while in four specimens the ischiococcygeus muscle was too large to be mobilized sufficiently. The mean working space was 24 mm with a range of 18 to 31 mm. It was considered that a working space of less than 20 mm would not be sufficient for manipulation of the instruments. With regards to pudendal nerve compression, it was observed that 7 (35%) of the 20 cadavers exhibited anatomic signs of PCS. In five (25%) specimens, the compression was observed betweenthe sacrospinous and sacrotuberous ligaments, while the other two (10%) exhibited a broader compression, by the falciform portion of the sacrotuberous ligament. Under the guidance of a laparoscope, the peritoneum was cut laterally to the bladder, and fascia pelvis was identified. The latter was split and the internal iliac vein was traced to the opening of the pudendal canal allowing clear visualization of its contents. Subsequently, either the sacrospinous or sacrotuberous ligament was cut. CONCLUSIONS: Considering that none of the surgical procedures currently used are known to completely improve all the symptoms of PCS, ILPCD could theoretically reduce stretching of the pudendal nerve.
机译：背景：阴部管综合症（PCS）是由阿尔科克管内的阴部神经受压或伸展引起的。方法：考虑到通过经会阴，经臀或经经椎弓根入路暴露阴部管和神经所涉及的难度和可能的并发症，采用腹腔内腹腔镜下阴囊管减压术（ILPCD）。对于这种技术，检查了30名成年男性尸体。结果：测量结果显示20个尸体中有16个（80％）具有足够的工作空间，而在四个标本中，异球菌肌肉太大而无法充分动员。平均工作空间为24毫米，范围为18至31毫米。人们认为，小于20 mm的工作空间不足以操纵仪器。关于阴部神经受压，观察到20具尸体中有7具（35％）表现出PCS的解剖体征。在五个（25％）样本中，was棘韧带和and结节韧带之间被压缩，而另外两个（10％）则被cro结韧带的镰状韧带所压缩。在腹腔镜的引导下，将腹膜切开至膀胱的侧面，并确定了骨盆筋膜。后者被劈开，internal内静脉被追踪到阴部管的开口，从而使内容物清晰可见。随后，切开sa棘或sa结节韧带。结论：考虑到目前尚无已知能完全改善PCS所有症状的手术方法，ILPCD理论上可减少阴部神经的伸展。

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