{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:03:34Z","timestamp":1756425814408,"version":"3.44.0"},"reference-count":7,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,12,12]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>The greater sciatic, lesser sciatic and obturator foramina are openings in the pelvis through which pelvic lesions can herniate, leading to the formation of rare dumbbell tumours. We present the case of a man in his late 60s, who presented with obstructed defecation. A per rectal examination revealed a palpable right sided rectal mass. MRI pelvis identified a dumbbell lipoma traversing the right sciatic foramen, with a pelvic component causing displacement of the rectum and a gluteal component impinging on the sciatic nerve. The lipoma was successfully removed by a multidisciplinary team using a dual approach: the pelvic component was excised laparoscopically, and the gluteal component was removed by an open approach. Comprehensive knowledge of pelvic anatomy is required to safely and accurately excise lesions in this region. Laparoscopic approach offers clear advantages over the open approach, while yielding similar results.<\/jats:p>","DOI":"10.1136\/bcr-2024-262238","type":"journal-article","created":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T01:30:30Z","timestamp":1735867830000},"page":"e262238","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Combined laparoscopic and gluteal approach for resection of a sciatic notch dumbbell lipoma"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7714-8167","authenticated-orcid":false,"given":"Ludia","family":"John","sequence":"first","affiliation":[{"name":"General Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1606-9868","authenticated-orcid":false,"given":"Narayanan D","family":"Cunnigaiper","sequence":"additional","affiliation":[{"name":"General Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1371-2096","authenticated-orcid":false,"given":"Chandru","family":"Ravindrakumar","sequence":"additional","affiliation":[{"name":"General Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1684-068X","authenticated-orcid":false,"given":"Rushab","family":"Ranawat","sequence":"additional","affiliation":[{"name":"General Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,1,2]]},"reference":[{"key":"2025082802124276000_18.1.e262238.1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02015800"},{"key":"2025082802124276000_18.1.e262238.2","doi-asserted-by":"crossref","first-page":"144","DOI":"10.24911\/ejmcr\/173-1654726166","article-title":"Dumbbell shaped giant intramuscular pelvic lipoma: a rare cause of sciatic nerve compression","volume":"6","author":"Jindal","year":"2022","journal-title":"EJMCR"},{"key":"2025082802124276000_18.1.e262238.3","doi-asserted-by":"crossref","first-page":"414","DOI":"10.5306\/wjco.v7.i5.414","article-title":"Bone and soft tissue tumors presenting as sciatic notch dumbbell masses: A critical differential diagnosis of sciatica","volume":"7","author":"Matsumoto","year":"2016","journal-title":"World J Clin Oncol"},{"key":"2025082802124276000_18.1.e262238.4","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1186\/s13019-021-01576-x","article-title":"A rare case of chest wall lipoma growing into the pleural cavity: a case report","volume":"16","author":"Jang","year":"2021","journal-title":"J Cardiothorac Surg"},{"key":"2025082802124276000_18.1.e262238.5","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-007-0364-8"},{"key":"2025082802124276000_18.1.e262238.6","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1111\/j.1445-2197.2011.05836.x","article-title":"A combined approach to the excision of sciatic notch dumb-bell tumours","volume":"81","author":"Kieser","year":"2011","journal-title":"ANZ J Surg"},{"key":"2025082802124276000_18.1.e262238.7","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1111\/ases.12700","article-title":"Laparoscopic resection of a dumbbell-shaped lipoma extending through the obturator foramen: A case report","volume":"13","author":"Kimura","year":"2020","journal-title":"Asian J Endosc Surg"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-262238","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:12:47Z","timestamp":1756372367000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-262238"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":7,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,2]]},"published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1136\/bcr-2024-262238"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-262238","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}