Clunealgie Clinical Trial
Official title:
New Endoscopic Minimal Invasive Approach for Pudendal Nerve and Inferior Cluneal Nerve Neurolysis: a Clinical Study
Pudendal nerve and cluneal nerve entrapment can cause a neuropathic pain syndrome in one,
many or all of the sensitive areas innervated by this nerve. In literature, several
techniques for the liberation of the pudendal nerve have been described. Here, transvaginal,
transperineal and abdominal laparoscopic approaches have been proposed, but none of the
latter were able to visualize the entire course of the nerve or allowed to explore the main,
currently identified sites of entrapment. Although there have been reports and series of case
reports on different surgical approaches, until now, the transgluteal approach is the only
one which is validated by a prospective randomized study comparing the medical treatment to
these surgical approach.
The investigators already performed a study to describe for the first time a new endoscopic
minimal invasive technique using a transgluteal approach which permits to visualize all the
nerve structures of the gluteal region. They performed an anatomic description of the region
reachable with this minimally invasive approach, and described the anatomic landmarks for the
visualization of the pudendal and cluneal nerve and their neurolysis.
In this study, the investigators would like to put in clinical practice this minimal invasive
approach for pudendal and cluneal neurolysis. They will perform this endoscopic approach, on
patients suffering from pudendalgie or/and clunealgie, who are programmed for a surgical
intervention by transgluteal approach.
The investigators would like to test the feasibility of the transgluteal trocar positioning
and if necessary, optimize this first important step. Secondly, they will put in practice the
step-by-step surgical approach that they have worked out during their cadaver study. Finally,
they will perform the entire neurolysis and nerve transposition under endoscopic control.
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