Femoral Nerve Injury Complicating Surgery for Gynecologic Cancer

Abstract

Femoral nerve injury during gynecologic cancer surgery was associated with the Bookwalter retractor. The pelvic blades of the retractor may exert a compression on the nerve. The weakened muscles suggest that the nerve compression occurred intrapelvically over the iliacus muscle. Shortening the time of maximal traction of the pelvic blades reduced the incidence of femoral nerve injury. When performing gynecologic surgery with the use of the Bookwalter retractor, care must taken with the placement of the pelvic blades.

Peripheral Neuropathy after Open Abdominal Surgery with Self-Retaining Retractors. A Systematic Review of Randomised and Non-Randomised Clinical Trials

“…Three of these studies were random control trials [5] [6] [7], two were retrospective and prospective analyses [8] [9] with the remaining five being retrospective analyses. Of these cases, two were chosen not to be included in the statistical summaries.…”

“…In the two papers in which both retrospective and prospective data were collected, the incidence was 2.9% (statistically significant) [8] and 25% (statistically not significant) [9].…”

“…One was a randomized controlled trial [7], one was a retrospective study [12] and two articles had both retrospective and prospective data in them [8] [9]. One was a case study of two cases and has been excluded from this discussion [10].…”

“…Within this requirement, a wide range of surgeries have been encompassed. These include tumour resection [8] [11], caesarean section [5] [6], hysterectomy [7], abdominal rectopexy [9] and general pelvic surgeries [10] [12]…”

Colonic adenocarcinoma encasing the femoral nerve: complete surgical excision with preservation of function

“…Further, an Australian study of 611 patients demonstrated that cytoreductive surgery can be successfully performed in the elderly with equally good results . Of note, femoral nerve injuries are not uncommonly reported after pelvic surgery in around 2% of cases . As use of retractors has previously been associated with the risk of nerve compression or impingement, we have employed gentle manual retraction and followed precise anatomical planes.…”