Preventing Nerve Damage in Laparoscopic Gynecologic Surgery: A Case Series

초록

Introduction/Background Nerve injuries during gynecologic surgery are infrequent but distressing complications that can result in significant patient discomfort and disability. This retrospective case analysis aims to highlight the occurrence and possible causes of nerve injuries during laparoscopic or robotic gynecologic surgery. We present seven cases of nerve injuries, with four involving upper limb damage and three involving lower limb damage, all of whom experienced nerve injuries in relation to their surgical procedures.Case Presentation The ages of the patients ranged from 42 years to 71 years, and the duration of the operations varied from 125 to 350 min. Neurological examination revealed motor and sensory dysfunction in the affected limbs, with varying degrees of severity. The prognosis and recovery differed among the cases, with continuous physical therapy being required for durations ranging from several months to up to 2 years.Conclusion The probable cause of nerve injury is most often attributed to the patient's posture during surgery. Prolonged operation time, high ASA scores, the presence of comorbidities, and elevated body mass index were identified as risk factors for nerve damage. Measures to prevent nerve injuries include maintaining precise patient positioning during surgery, avoiding the overextension of arms and hips, and utilizing advanced leg stirrups for better adjustment in the lithotomy position. Our results emphasize the significance of meticulous surgical positioning and continuous monitoring to avoid neurological complications during laparoscopic and robotic gynecologic surgeries. By implementing appropriate posture and positioning techniques, surgeons can significantly reduce the risk of nerve injuries and thereby improve patient outcomes. Attention to these preventive measures is critical for ensuring positive surgical outcomes and patient well-being.

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