A young woman's ability to walk and quality of life were restored after a rare, benign tumor was removed from her lesser pelvis using laparoscopic surgery at Semmelweis University's Department of Obstetrics and Gynecology, according to a June 26 announcement. The procedure involved interdepartmental collaboration between the Department of Obstetrics and Gynecology and the Department of Neurosurgery and Neurointervention, supported by intraoperative electrophysiological monitoring.
The operation took place on May 6 at Semmelweis University. The neuropelveology team worked closely with neurosurgeons led by Dr. Loránd Erőss, Director of the Department of Neurosurgery and Neurointervention, along with electrophysiologist Dr. Boglárka Hajnal and neurology resident Dr. Borbála Damó-Csorba. "In this case, we encountered a very rare variant of schwannoma: a tumor growing in the retroperitoneal space behind the uterus in the lesser pelvis, which accounts for 1–3 percent of all schwannomas," said Dr. Loránd Erőss.
Dr. Attila Bokor, Head of the Endometriosis Center and laparoscopic surgery unit at the Department of Obstetrics and Gynecology, said that recognizing this unique clinical picture required extreme caution due to its location near sensitive nerves and organs. He requested collaboration with neurosurgeons for electrophysiological monitoring during surgery. During the five-hour procedure at Baross Street section, surgeons used a 32-channel electrode system to continuously monitor nerve bundles around the tumor site.
"From a neurosurgical perspective, the challenge of the surgery was the laparoscopic localization of the tumor, but Dr. Attila Bokor's laparoscopic experience managed to overcome it," said Dr. Loránd Erőss. Using neurostimulation during dissection allowed precise identification and preservation of nerves running along the surface while removing sections of tumor tissue.
The surgical team also faced challenges because multiple nerve roots were affected by compression from both within their origin point as well as neighboring areas controlling rectum, bladder, and vagina functions—preservation being among their primary goals alongside eliminating pain and removing tumorous tissue entirely.
Dr. Attila Bokor noted that such procedures are rare; only two or three are performed every three months in Hungary or neighboring countries—making this group unique regionally for such operations even compared to most European centers.
