This is a 25min summary of a 4h surgical procedure of complete excision of 2 deep endometriosis nodules infiltrating the left parametrium, the S3, the sciatic nerve and the low rectum.
The movie is free of comments, however following the surgery is affordable for those surgeons who have knowledge on perm atrium anatomy.
The patient is 31 year old, and presents with catamenial sciatic pain requiring morfine, motor weakness of the left leg, dyschesia, deep dyspareunia.
MRI reveals 2 connected nodules:
N° 1: a type 1 deep nodule of the left parametrium nodule infiltrating the rectum, on contact with the left S3
N° 2: a type 2 deep nodule on contact with the sciatic nerve, sciatic foramen and lateral pelvic wall
To read more about the surgery of sacral plexus and sciatic nerve, please see the following article available in Open Access: doi: 10.1016/j.jmig.2020.10.018.