Postoperative Lower Extremity Neuropathy With Boot Stirrups Compared With Candy Cane Stirrups

Whitis, Avery M; Chen, Edison; Sekhon, Morgan; Akella, S.; Bradley, Catherine S.; Kowalski, Joseph T.

doi:10.1097/aog.0000000000004353

Cited by 4 publications

(3 citation statements)

References 12 publications

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“…In contrast to our study, other groups reported that the use of candy canes compared to the use of boot stirrups are at greater risk for a postoperative neuropathy in gynecologic surgery, proposing a better placement in boot stirrups [ 21 , 22 ]. As our finding was contrary to the recent literature and boots stirrups had been implemented as standard positioning device in our department since several years, repeated intraoperative positioning controls were implemented as a standard operating procedure in our department.…”

Section: Discussioncontrasting

confidence: 99%

Postoperative Femoral Nerve Palsy and Meralgia Paresthetica after Gynecologic Oncologic Surgery

Egger

Sezer

Condic

et al. 2022

JCM

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Femoral nerve palsy and meralgia paresthetica following gynecologic cancer surgery are rare, but severe and long lasting. Here, we aimed to study their incidence, severity, possible risk factors and its time to remission. Between January 2008 and December 2017 976 gynecologic cancer patients were identified in our institutional database receiving surgery. Complete patient charts were reviewed retrospectively. Possible risk factors were analyzed by Fisher’s exact test. 441 (45.18%) out 976 were treated for Ovarian cancer. In total 23 patients were identified with a postoperative neurological leg disorder. A femoral nerve palsy was present in 15 patients (1.5%) and a meralgia paresthetica in 8 patients (0.82%). Three patients showed both disorders. Duration of surgery (p = 0.0000), positioning during surgery (p = 0.0040), femoral artery catheter (p = 0.0051), prior chemotherapy (p = 0.0007), nicotine abuse (p = 0.00456) and prior polyneuropathy (p = 0.0181) showed a significant association with a postoperative femoral nerve palsy. Nicotine abuse (p = 0.0335) and prior chemotherapy (p = 0.0151) were significant for the development of a meralgia paresthetica. Long lasting surgery, patient positioning and femoral arterial catheter placement are risk factors for a postoperative femoral nerve palsy in gynecologic cancer surgery. Polyneuropathy, nicotine abuse, and prior chemotherapy are predisposing risk factors for a femoral nerve palsy and a meralgia paresthetica. A resolution of symptoms is the rule for both disorders within different time schedules.

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Section: Discussioncontrasting

confidence: 99%

Postoperative Femoral Nerve Palsy and Meralgia Paresthetica after Gynecologic Oncologic Surgery

Egger

Sezer

Condic

et al. 2022

JCM

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“…The common peroneal nerve, which runs very close laterally to the head of the fibula, can be injured following inappropriate placement of the patient’s legs in the stirrups, while extreme flexion of the hip may cause femoral nerve injury [ 191 ]. The use of candy cane stirrups is associated with a threefold increased risk of lower extremity postoperative neuropathy compared with boot stirrups [ 193 ]. Low patient’s BMI, prolonged time spent in the lithotomy position, and insufficient padding of leg supports are additional risk factors for perioperative lower limb neuropathies [ 187 ].…”

Section: Methodsmentioning

confidence: 99%

Complications in laparoscopic and robotic-assisted surgery: definitions, classifications, incidence and risk factors - an up-to-date review.

Watrowski

Kostov

Alkatout

2021

Videosurgery and Other Miniinvasive Techniques

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Almost all gynecological and general-surgical operations are – or can be – performed laparoscopically. In comparison to an abdominal approach, the minimally invasive access offers several advantages; however, laparoscopy (both conventional and robotic-assisted) can be associated with a number of approach-specific complications. Although the majority of them are related to the laparoscopic entry, adverse events may also occur due to the presence of pneumoperitoneum or the use of laparoscopic instruments. Unfortunately, a high proportion of complications (especially affecting the bowel and ureter) remain unrecognized during surgery. This narrative review provides comprehensive up-to-date information about definitions, classifications, risk factors and incidence of surgical complications in conventional and robotic-assisted laparoscopy, with a special focus on gynecology. The topic is discussed from various perspectives, e.g. in the context of stage of surgery, injured organs, involved instruments, and in relation to malpractice claims.

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“… 3 , 4 With the advancement of medical technology and the increasing focus on the well-being of surgical patients, the lithotomy position with stirrup support is being used more frequently in clinical practice. 5 The stirrup provides greater comfort to the patient compared to the traditional lithotomy leg support. Additionally, it reduces the workload for nurses and allows for more precise positioning.…”

Section: Introductionmentioning

confidence: 99%

A Randomized Controlled Comparative Study of the Three Over-Bed Techniques for Positioning and Repositioning the Lithotomy Position While Using Stirrups

Zhang,

Luo,

Yang

2023

JMDH

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Objective In this study, the clinical application and efficacy of three different methods for placing and repositioning patients in the lithotomy position over the bed using stirrups were evaluated. Methods A total of 240 surgical patients who underwent surgery in Chongqing Traditional Chinese Medicine Hospital between July and November 2022 were selected as study participants. Using envelopes, they were randomly divided into three groups of 80 cases each using a randomization method. The groups included the traditional over-bed method, the postural trolley-assisted over-bed method, and the direct over-bed method. Using the Kruskal–Wallis rank-sum test, analysis of variance, and multiple linear regression equations, the placement time, over-bed repositioning time, and total time of the three methods for placing and repositioning in the lithotomy position supported by stirrups were analyzed statistically. In addition, we investigated and examined the satisfaction of nurses and doctors with the aforementioned techniques. Results The placement time, repositioning time, and total time were significantly higher for the traditional over-bed method than for the postural trolley-assisted over-bed method and the direct over-bed method (both P < 0.01). However, there was no statistically significant difference between the postural trolley-assisted over-bed method and the direct over-bed method ( P > 0.05). Nurses and doctors reported significantly higher satisfaction with the postural trolley-assisted over-bed method and the direct over-bed method compared to the traditional over-bed method (both P < 0.01). In addition, nurses were more satisfied with the direct over-bed method than the postural trolley-assisted over-bed method ( P < 0.05). Conclusion The results of this study demonstrate that the direct over-bed method is preferred for positioning and repositioning patients in the lithotomy position with the support of stirrups.

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Postoperative Lower Extremity Neuropathy With Boot Stirrups Compared With Candy Cane Stirrups

Abstract: Personal or nonessential information may be redacted at the editor's discretion.

Cited by 4 publications

References 12 publications

Postoperative Femoral Nerve Palsy and Meralgia Paresthetica after Gynecologic Oncologic Surgery

Postoperative Femoral Nerve Palsy and Meralgia Paresthetica after Gynecologic Oncologic Surgery

Complications in laparoscopic and robotic-assisted surgery: definitions, classifications, incidence and risk factors - an up-to-date review.

A Randomized Controlled Comparative Study of the Three Over-Bed Techniques for Positioning and Repositioning the Lithotomy Position While Using Stirrups

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