Abstract
The advent of total mesorectal excision (TME) together with minimally invasive techniques such as laparoscopic colorectal surgery and robotic surgery has improved surgical results. However, the incidence of bladder and sexual dysfunction remains high. This may be particularly distressing for the patient and troublesome to manage for the surgeon when it does occur. The increased use of neoadjuvant and adjuvant radiotherapy is also associated with poorer functional outcomes. In this review, we evaluate current understanding of the anatomy of pelvic nerves which are divided into the areas of the inferior mesenteric artery pedicle, the lateral pelvic wall and dissection around the urogenital organs. Surgical techniques in these areas are discussed. We also discuss the results in functional outcomes of the various techniques including open, laparoscopic and robotic over the last 30 years.
Original language | English |
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Pages (from-to) | 173-185 |
Number of pages | 13 |
Journal | Gastroenterology Report |
Volume | 4 |
Issue number | 3 |
DOIs | |
Publication status | Published - Aug 2016 |
Externally published | Yes |
Bibliographical note
Copyright the Author(s) 2016. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.Keywords
- total mesorectal excision
- pelvic autonomic nerve preservation
- urinary dysfunction
- sexual dysfunction