Robotic Surgery in Pudendal Neurolysis (as Robotic Pudendal Nerve Decompression Surgery)

This article describe how pudendal nerve neurolysis can be managed safely with robotic surgery

The pudendal nerve is formed from spinal roots at levels S2, S3 and S4. It passes through the pelvis parallel to the pudendal vein and artery. Pudendal nerve exits the pelvis between the sacrospinous and sacrotuberous ligaments then passes through Alcock’s canal.

Pudendal nerve can be compressed and responsible for pain in the pelvic and perineal regions. Pudendal nerve entrapment syndrome (PNE) is characterized by presence of neuropathic pain in the pudendal nerve territory and associated with urinary, defecatory and sexual symptoms.

Surgical pudendal nerve decompression is an effective and safe alternative for highly selected cases when conservative treatment fails.

Pudendal nerve neurolysis can be successfully achieved with robotic surgery with its high definition augmented view and less invasive advantages. As previously described laparoscopic approach for pudendal neurolysis, robotic surgery has more advantages with stable high definition view and robotic arms, resulting in clear view and non-vibrated instruments for gentle handling of nerve dissection.

The neurolysis of the pudendal nerve using robotic surgery can be an effective and safe surgery with high success rate in patients with PNE.

Prof. Tibet Erdogru, M.D. first describe laparoscopic surgery approach for pudendal nerve decompression in the world in 2014 (the first clinical laparoscopic pudendal surgery in the literature: https://pubmed.ncbi.nlm.nih.gov/24149853/ ).

He has also firstly described laparoscopic pudendal neurolysis in the patients with PNE due to pelvic mesh surgery ( Please click to https://pubmed.ncbi.nlm.nih.gov/27250921/ ) and laparoscopic selective pudendal nerve neuromodulation in neurogenic bladder ( Please click to https://pubmed.ncbi.nlm.nih.gov/32395321/ )

With his advanced experience in pelvic laparoscopic and robotic surgeries at uro-oncology field, Prof. Tibet Erdogru has switched to robotic pudendal nerve decompression surgery from laparoscopic neurolysis since 2021 in selected cases with technical advantages of daVinci robotic surgery as high definition 3D magnified and steady view, minimal invasive surgery, non-shaking robotic instruments.

Medical articles of Prof. Tibet Erdogru, M.D.

https://pubmed.ncbi.nlm.nih.gov/?term=erdogru%20t&page=2