Ilio sacral tumors and pelvic nerve tumors

Highly specialized pelvic surgery

Anyone who suffers from a tumor in the sacral region, the coccyx or the pelvic nerves, understands that the removal of such tumors poses a particular challenge to the surgeon. We are well aware of the fact that this knowledge increases the concerns of patients about their own wellbeing. Laparoscopy is a gentle surgical procedure that provides a high degree of reliability. The Possover International Medical Center is the only center worldwide that performs laparoscopically assisted orthopedic surgery of the pelvic bone and nerve tumors.

Tumors of the Pelvic Bones

Tumors of the Pelvic Bones

Orthopaedic Surgery using Laparoscopy

The primary treatment for sacral tumors comprises the complete surgical removal (resection) of the tumor-like formations with large tumor-free margins and functional reconstruction.

In cases where the tumour has settled in the upper part of the sacrum, such a surgical intervention poses a particular challenge in sacral tumor surgery. The main reason for this being the difficulty in accessing the surgical area. In addition, the procedure involves a greater risk of bleeding during and after the operation, due to the increased blood supply to the tumor. A further risk is the injury of the adjacent nerves and organs, such as the ureter and rectum.

Tumors forming on the pelvic bones also include teratomas, osteochondro-sarcoma and others.

Treatment of tumors of the sacrum and coccyx

Treatment of tumors of the sacrum and coccyx

Tumors of the sacrum and coccyx: increased safety thanks to laparoscopic procedures

The treatment of tumors affecting both the sacrum and coccyx - so-called sacrococcygeal tumors - requires the removal of the affected parts of the sacrum and coccyx. This operation is performed by orthopaedic oncologists. The primary laparoscopic access to the pelvis, i.e. the use of an instrument with a tiny camera and light, enables precise visualization of the ureter, rectum and pelvic nerves. This visualization helps the surgeon to avoid injuries during the procedure. Furthermore, all pelvic blood vessels that supply the tumor can be sealed laparoscopically, preventing massive blood loss during the procedure. At the same time, the tumor can be removed with precision using adapted tumor-free resection margins.

Tumors of the pelvic nerves

Tumors of the pelvic nerves

Schwannoma: benign tumors also require removal

Schwannomas are benign and usually slow-growing tumors of the peripheral nervous system that develop from the Schwann cells. It is the task of the Schwann cells to coat the nerve fibres.

Schwannomas do not necessarily impair nerve function, but lead to deformation and compression of the nerve fibre bundles with increasing growth of the tumor. This development can result in neuropathic pain of the sciatic nerve, the vulva, the coccyx or the pubic bone. In the most severe cases, the affected nerves are then paralyzed.

Surgical investigation (exploration) and the removal of Schwannomas is absolutely essential. This procedure must be performed in order to histologically verify the benignity of the tumor. Malignant degeneration of Schwannomas is extremely rare, but can still occasionally occur.

Treatment of pelvic nerve tumors

Treatment of pelvic nerve tumors

Minimally invasive removal with laparoscopy   

The surgical removal of schwannomas poses a particular challenge to the surgeon, as their anatomical position makes access difficult. Due to the extremely good blood supply in the pelvis, such an operation is associated with a high risk of bleeding during or after the procedure. The surgical treatment of such tumors within the pelvis is highly invasive in classical neurosurgery because the pelvic bone usually has to be removed in order to gain access to the tumor.

By using laparoscopy, the tumour can be reached from the front without removing the pelvic bone. Special rod lens optics (rigid endoscopes) are inserted through small openings in the abdominal wall created by the surgeon. This procedure - laparoscopic exploration - allows a minimally invasive approach that permits both complete removal and histological confirmation of the tumor. In addition, intraoperative blood loss is reduced because the camera can monitor the blood supply to the tumor.

Visual identification of the rectum, ureter and pelvic nerves is safer and much simpler with laparoscopic surgery than with conventional neurosurgery, where the pelvic bone has to be removed. In most patients with nerve root schwannomas, laparoscopic surgery improves symptoms. A postoperative deterioration is not to be expected, as the sacral nerve roots are spared.

The Possover International Medical Center is the only center worldwide that performs laparoscopic-assisted orthopedic surgery on pelvic bone and nerve tumors.

Prof. Marc Possover MD

To help people in difficult situations to improve their quality of life has become his life's passion. Continuous research, decades of clinical experience and the focused determination to find a solution for previously unsolved medical problems, have enabled Prof. Possover to help often quite discouraged patients find release from their seemingly insurmountable problems.

Possover International Medical Center

Our center of excellence for Neuropelveology in Zürich is equipped with state of the art technical equipment, offering world-class treatment at the highest level. Enjoy individual attention in the most private and comfortable of settings.

Our team will take care of you

Here at our center, you will be treated not only as our valued patient but as our guest. Everyone in Prof. Possover's team is committed to making you feel completely at ease and in very safe hands. Our internationally experienced team members have an intuitive feel for the particular needs of every individual. We will accompany you every step of the way, from the initial contact right through to the conclusion of your treatment - with detailed personal attention, sincerity, courtesy and careful understanding.

Back to a better quality of life

We will dedicate our expertise and know-how to help you find the solution that is right for you.

Audrey Schroller

Practice Assistant

„As a cheerful, open and communicative person, I really appreciate coming into contact with people from all over the world. The well-being of others is very important to me.

Involvement of your own physician in your treatment

If it is your preference, your attending doctor is welcome to accompany you to Zürich. You will then have a person at your side who is familiar with your medical concerns. At the same time, your doctor will have the opportunity to be present during the planned operation and gain unique insights into the applied practice of Neuropelveology.
Photo Neuropelveology Nerve Tracts

Discovering the pelvic nerves

Neuropelveology is a medical discipline developed by Prof. Possover. It is based on the discovery of the pelvic nerves and includes the diagnosis of the diseases of these nerves by means of gynaecological examination methods and their treatment by means of laparoscopy.

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