Lower extremity latrogenic nerve injury due to compression during intraabdominal surgery

Ellen D. Dillavou, L. Roderick Anderson, Richard A. Bernert, Richard A. Mularski, Glenn C. Hunter, Steven M. Fiser, William - Adamas-Rappaport

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

BACKGROUND: Iatrogenic nerve injury due to poor positioning and external compression is a common surgical complication. However, sciatic neuropathy from external compression and femoral nerve injury after self-retaining retraction are less-published complications. METHODS: Surgical Morbidity and Mortality Reports from 1986 through 1995 were reviewed to identify femoral and sciatic neuropathies following intraabdominal vascular and general surgeries. RESULTS: Two sciatic and 5 femoral neuropathies were reported, an incidence of approximately 0.17% of abdominal cases. Sciatic injuries were attributed to external compression, whereas femoral neuropathies were due to compression by self-retaining retraction. The 3 female and 4 male patients had a mean age of 53.4 years, and no patient had a prior history of peripheral neuropathy. Mean operating time for sciatic injuries was 8.2 hours, versus 4.3 hours for femoral neuropathies. Both patients with sciatic neuropathy had complete resolution of symptoms, compared with 1 femoral neuropathy patient. Two femoral neuropathies were permanent, 1 had partial resolution and 1 had improvement at 4 months but was lost to follow-up. CONCLUSIONS: Sciatic and femoral compression neuropathies are rare but serious complications of abdominal surgery. When retracting in the deep pelvis, consideration should be given to using small, well-padded retractor blades and repositioning these regularly. Prevention of sciatic nerve compression requires careful padding of the table surface, especially for longer cases.

Original languageEnglish (US)
Pages (from-to)504-508
Number of pages5
JournalAmerican Journal of Surgery
Volume173
Issue number6
DOIs
StatePublished - Jun 1997

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Femoral Neuropathy
Lower Extremity
Sciatic Neuropathy
Wounds and Injuries
Femoral Nerve
Lost to Follow-Up
Peripheral Nervous System Diseases
Sciatic Nerve
Pelvis
Blood Vessels
Morbidity
Mortality

ASJC Scopus subject areas

  • Surgery

Cite this

Dillavou, E. D., Anderson, L. R., Bernert, R. A., Mularski, R. A., Hunter, G. C., Fiser, S. M., & Adamas-Rappaport, W. . (1997). Lower extremity latrogenic nerve injury due to compression during intraabdominal surgery. American Journal of Surgery, 173(6), 504-508. https://doi.org/10.1016/S0002-9610(97)00015-9

Lower extremity latrogenic nerve injury due to compression during intraabdominal surgery. / Dillavou, Ellen D.; Anderson, L. Roderick; Bernert, Richard A.; Mularski, Richard A.; Hunter, Glenn C.; Fiser, Steven M.; Adamas-Rappaport, William -.

In: American Journal of Surgery, Vol. 173, No. 6, 06.1997, p. 504-508.

Research output: Contribution to journalArticle

Dillavou ED, Anderson LR, Bernert RA, Mularski RA, Hunter GC, Fiser SM et al. Lower extremity latrogenic nerve injury due to compression during intraabdominal surgery. American Journal of Surgery. 1997 Jun;173(6):504-508. https://doi.org/10.1016/S0002-9610(97)00015-9
Dillavou, Ellen D. ; Anderson, L. Roderick ; Bernert, Richard A. ; Mularski, Richard A. ; Hunter, Glenn C. ; Fiser, Steven M. ; Adamas-Rappaport, William -. / Lower extremity latrogenic nerve injury due to compression during intraabdominal surgery. In: American Journal of Surgery. 1997 ; Vol. 173, No. 6. pp. 504-508.
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