Abstract
Near-Infrared Intraoperative Imaging of Pelvic Autonomic Nerves: Clinical Trial
Highlights
The pelvic autonomic nerves control and regulate anorectal and urogenital function
Some nerve-sparing surgery techniques were invented to help surgeons to minimize the injury to pelvic autonomic nerves by separating the deep uterine vein and the splanchnic plexus when dividing the parametrial tissue with the middle rectal artery as a landmark [13]
The intraoperative indocyanine green (ICG) fluorescence imaging was applied in our trial to identify the splanchnic plexus along the ureter, inferior mesenteric artery plexus around the inferior artery roots, and sacral plexus along the lateral rectum ligaments (Fig. 2)
Summary
The pelvic autonomic nerves control and regulate anorectal and urogenital function. The dysfunction of pelvic autonomic nerves lead to disorders of anorectum, bladder and male sex organs. The intraoperative identification of pelvic autonomic nerves could be crucial in complications prevention and diseases treatment. [3] Currently, stimulation of pelvic autonomic nerves is the main treatment method for anal-bladder functional disturbances [4], including underactive bladder [5], bladder-sphincter dyssynergia, and anorectal dysfunction [6]. Possover et al and Katahira et al applied an intraoperative neuronavigation technology in surgery, visualizing the splanchnic nerve pathways by stimulating the separate splanchnic plexus [16, 17]. These techniques could reduce postoperative complication rates, the various small nerve fibers are not be able to be preserved by these methods
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