Australian First at Prince Of Wales Private Hospital

An Australian first has been performed at Prince of Wales Private Hospital, providing swifter relief and recovery for chronic pain due to pudendal nerve entrapment.

Gynaecologists Professor Thierry Vancaillie and Dr Jason Chow have successfully completed Australia’s first robotic laparoscopic pudendal nerve release - a procedure developed in response to a growing need to address pudendal nerve pain.

The condition is believed to be the result of a congenital anomaly of the anatomic structures of the pelvis, leading to entrapment (or compression) of the nerve.

The successful operation means Australia joins the US, Spain and Belgium in offering this ground-breaking procedure.

Dr Chow said pudendal nerve pain was common, with the Women’s Health and Research Institute treating up to 20 cases a year, and the robotic laparoscopic procedure was superior to existing methods to treat the condition.

“Comparing to the conventional approach of pudendal nerve release, the robotic laparoscopic approach is much superior, as it allows accurate manipulation of the blood vessels and other delicate structures within the pelvic area, which means accurate exposure with lesser risk of bleeding,” Dr Chow said.

Professor Vancaillie and Dr Chow performed the procedure for the first time on December 13 2018 at Prince of Wales Private Hospital. Professor Vancaillie said the patient was recovering well.

“I would like to thank the Prince of Wales Private Hospital for facilitating this historic event,” Professor Vancaillie said.

The Women’s Health and Research Institute started a dedicated pudendal pain clinic in 2007, and the institute’s specialists visited colleagues in Europe in subsequent years to learn more about treating the condition, including a trans-gluteal, or a posterior approach, for release of the nerve.

“We became gradually aware that the anatomical distortion needed to perform the trans-gluteal approach was not ideal,” Professor Vancaillie said.

“In the meantime, reports of successful laparoscopic nerve release became more frequent. The technical advantages offered by robotic laparoscopic surgery allow the surgeon to operate in narrow and tight spaces. This is exactly what we considered was required for a successful pudendal nerve release.

“Dr Chow started his training to use the laparoscopic robot and we recruited a patient in whom we anticipated ideal anatomic conditions. This culminated in the performance of the first laparoscopic pudendal nerve release in Australia.”