The “LANN” technique for exposure of pelvic nerves in women - experience in 1218 cases

Introduction The pelvic splanchnic nerves were first described as nervi erigentes by Eckhardt in 1863 (1). Since this time, the neuroanatomy of the pelvic plexus using cadaveric microdissection and serial histologic sectioning in human fetuses or using the immunohistochemy technique has been well explored. With the introduction of laparoscopy into the field of pelvic retroperitoneal surgery, laparoscopic exposure and dissection to all pelvic somatic and autonomous nerves has become possible and intraoperative elaboration of a functional cartography of the inferior hypogastric plexus using the LAparoscopic Neuro-Navigation LANN-technique was established (2). In the actual work we report on our anatomical findings concerning the laparoscopic exposure, preservation (nervesparing), decompression and electrostimulation of the sacral nerves roots, especially S2-4 in their endopelvic portion, and of the pelvic splanchnic nerves during laparoscopic pelvic surgery.