open access

https://hdl.handle.net/2115/97454

Internal Hernia Beneath the Obturator Nerve After Robot-Assisted Radical Cystectomy and Pelvic Lymphadenectomy : A Case Report With Literature Review

英語

Strangulated intestinal obstruction

2025-02-10

John Wiley & Sons

Asian journal of endoscopic surgery

18(1)

e70030

A man in his 40's presented with vomiting and numbness in the right thigh. Eight months earlier, he had undergone robot-assisted radical cystectomy and pelvic lymphadenectomy for bladder cancer. Computed tomography (CT) revealed a caliber change and a closed loop of the small intestine in the right pelvis, prompting emergency diagnostic laparoscopy. Intraoperative findings showed that the small intestine had herniated into the space between the right obturator nerve and pelvic wall, resulting in strangulated intestinal obstruction. The necrotic small intestine was resected and reconstructed, while preserving the obturator nerve. The hernia orifice was not repaired during the surgery. We encountered a rare case of an internal hernia involving the obturator nerve as the cord. In patients with abdominal distension and thigh symptoms following pelvic lymphadenectomy, internal hernia should be considered. The optimal approach for hernia repair involving the obturator nerve remains undetermined, necessitating a case-by-case approach.

学術雑誌論文

Accepted Manuscript

This is the peer reviewed version of the following article: Naito, Z., Wada, M., Shichinohe, T., Yoshida, A., Osawa, T., Abe, T. and Hirano, S. (2025), Internal Hernia Beneath the Obturator Nerve After Robot-Assisted Radical Cystectomy and Pelvic Lymphadenectomy: A Case Report With Literature Review. Asian J Endosc Surg, 18: e70030, which has been published in final form at https://doi.org/10.1111/ases.70030. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.

1758-5902

1758-5910