Femoral neuropathy after vaginal surgery: A complication of the lithotomy position

Wilson, Moira; Ramage, Lisa; Yoong, Wai; Swinhoe, June

doi:10.3109/01443615.2010.528082

Cited by 9 publications

(9 citation statements)

References 5 publications

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“…12,16 A significant complication is injury to the femoral nerve that can be permanent and has been rarely reported in the urologic literature. 17 Although we did not show a statically significant change in complication rate, prevention of this complication would likely result from decreasing operative time, taking meticulous care to position the patient with attention to hip flexion, and rechecking if the patient was suspected of sliding on the table. The “learning curve” has been shown to have an important effect on complications but is not likely to be the sole difference in reducing complications.…”

Section: Commentmentioning

confidence: 58%

Preventing Perioperative Complications of Robotic-assisted Radical Prostatectomy

Liss

Skarecky

Morales

et al. 2013

Urology

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OBJECTIVE To report the change in complication rates after the identification and modification of technique to reduce their incidence during robot-assisted radical prostatectomy (RARP). METHODS This study retrospectively reviewed 1000 consecutive patients who underwent RARP from June 2002 to June 2011. A number of technical changes were made after complications were noted and changes in technique were documented. The Fisher exact test and multivariate analysis were used for comparison of techniques, and values of P <.05 were considered significant. RESULTS The overall rate of major and minor complications was 10.8% (108 of 1000). The complication rates of lymphoceles (0.4%), ileus (0.4%), and wound infection (0.4%) were low and did not require technical changes. There were no significant changes in rates of femoral nerve palsies, rectal injuries, or bladder neck contractures. There was statistically significant change in corneal abrasions (P = .03), fossa navicularis strictures (P = .03), and camera-site hernias (P <.001) after a directed intervention adjusted for age, body mass index, and learning curve. Clavien 3 and 4 complications all significantly decreased to ≤0.6%, with the most occurring in the first 200 cases. CONCLUSION Identification and correction of perioperative complications in patients undergoing robotic prostatectomy has decreased the incidence of major and minor complications adjusted for learning curve. The conscientious monitoring of adverse events can provide targeted change in technique to decrease complications and provide information to those early in learning robotic-assisted radical prostatectomy.

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Section: Commentmentioning

confidence: 58%

Preventing Perioperative Complications of Robotic-assisted Radical Prostatectomy

Liss

Skarecky

Morales

et al. 2013

Urology

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“…With the increasing diversity in the type and extent of surgical procedures, clinicians need to pay more attention to postoperative iatrogenic femoral neuropathy. In fact, postoperative femoral neuropathy has been reported in a number of cases in gynecology, in vascular surgery, and in renal transplantation [3-5]. …”

Section: Discussionmentioning

confidence: 99%

Lumbar Plexopathy Caused by Metastatic Tumor, Which Was Mistaken for Postoperative Femoral Neuropathy

et al. 2011

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Surgical excision was performed on a 30-years old woman with a painful mass on her left thigh. The pathologic findings on the mass indicated fibromatosis. After the operation, she complained of allodynia and spontaneous pain at the operation site and ipsilateral lower leg. We treated her based on postoperative femoral neuropathy, but symptom was aggravated. We found a large liposarcoma in her left iliopsoas muscle which compressed the lumbar plexus. In conclusion, the cause of pain was lumbar plexopathy related to a mass in the left iliopsoas muscle. Prompt diagnosis of acute neuropathic pain after an operation is important and management must be based on exact causes.

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“…The patient's hips are particularly vulnerable to excessive rotation and hyperabduction . Excessive rotation or abduction (ie, more than 30 to 45 degrees) puts stress on the patient's hip joints and can cause a femoral, sciatic, obturator, or common peroneal neuropathy . When using candy cane–shaped leg holders, there is potential for the patient's lower extremities to rest against the vertical leg‐holder posts, which increases the patient's risk for injury to the common peroneal nerve .…”

Section: Selecting Leg Holders For Use When a Patient Is In The Lithomentioning

confidence: 99%

“…5,9 Excessive rotation or abduction (ie, more than 30 to 45 degrees) puts stress on the patient's hip joints and can cause a femoral, sciatic, obturator, or common peroneal neuropathy. 5,7,[10][11][12][13][14][15][16] When using candy caneshaped leg holders, there is potential for the patient's lower extremities to rest against the vertical leg-holder posts, which increases the patient's risk for injury to the common peroneal nerve. 10,11,14,16 An injury to the common peroneal nerve can cause a paresthesia of the lateral lower leg and dorsum of the foot and result in foot drop.…”

Section: Answermentioning

confidence: 99%

Clinical Issues—January 2018

Cahn¹,

Wicklin²

2018

AORN Journal

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Femoral neuropathy after vaginal surgery: A complication of the lithotomy position

Cited by 9 publications

References 5 publications

Preventing Perioperative Complications of Robotic-assisted Radical Prostatectomy

Preventing Perioperative Complications of Robotic-assisted Radical Prostatectomy

Lumbar Plexopathy Caused by Metastatic Tumor, Which Was Mistaken for Postoperative Femoral Neuropathy

Clinical Issues—January 2018

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