- Academic Editor
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Background: This study aims to present a novel technique that
integrates intraoperative neurophysiological monitoring (IONM) into laparoscopy
for continuous monitoring of pelvic nerves at risk during surgery to ensure their
protection. Methods: This is a prospective analysis of 10
consecutive patients receiving surgical treatment for proven diagnosis of
lumbosacral plexus nerve entrapment. Patients with symptoms of chronic pelvic
pain, dyspareunia, dysmenorrhea, and severe, burning sharp pain on the lower
extremity dermatomes were included. Laparoscopic decompression of lumbosacral
plexus nerve entrapment with intraoperative neuromonitoring was performed between
January 2021 and February 2022. Intraoperative neuromonitoring records
(spontaneous electromyography (EMG), free-run EMG recordings, transcranial electrical motor-evoked
potentials (TcMEP) recordings, direct nerve root stimulation recordings, and
compound muscle action potentials (CMAPs) recordings) and preoperative and
postoperative pain symptoms at one month were analyzed. Results:
The median age of the patients was 29 (25–44) years. Neurovascular conflict,
fibrosis, and abnormal piriformis muscle were identified as the three main
etiologies of nerve entrapments. There were no statistically significant
differences in transcranial motor evoked potential responses on the
operated extremity side before and after decompression surgery or in the
amplitude difference changes of TcMEP responses between the operated and
non-operated extremity sides (p