OP Note:

Neuroplasty of right lateral femoral cutaneous nerve distal to the inguinal ligament
*
Neurectomy of the right lateral femoral cutaneous nerve and the retroperitoneal space.

patient was taken to the operating room and placed in supine position. Right side of the abdomen and right proximal thigh were prepped and draped in normal fashion. Timeout performed.
*
A retroperitoneal exposure was performed by the general surgery service as co-surgeons for this procedure.
*
As we explored the retroperitoneal space and the area along the iliac is possible we’re unable to clearly identify the lateral femoral cutaneous nerve. This was likely secondary to previous surgery and some scarring. The incision was undermined and we started to expose more distally along the inguinal ligament. At the junction of the inguinal ligament and the anterior superior iliac spine, dissection proceeded. We moved just distal to the inguinal ligament and were able to identify the lateral femoral cutaneous nerve as it was exiting from under the ligament into the thigh. We then traced the nerve proximal under the inguinal ligament towards the retrograde peritoneal space. This allowed us to then identify the nerve In the retroperitoneal space. Gentle neuroplasty was now performed as we exposed the nerve over at least a distance of 2-3 cm In the retroperitoneal space. This was proximal to the likely pathology for the patient.. The nerve was fully divided. The proximal stump was then rotated and a opening was placed in the iliac’s muscle. Proximal stump was then buried into the muscle.

Thanks so much,
Tracy

*