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Neurologic injury and patient displacement in gynecologic laparoscopic surgery using a beanbag and shoulder supports
Author(s) -
Treszezamsky Alejandro D.,
Fenske Suzanne,
Moshier Erin L.,
AscherWalsh Charles J.
Publication year - 2018
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12325
Subject(s) - medicine , interquartile range , surgery , trendelenburg position , displacement (psychology) , retrospective cohort study , hysterectomy , laparoscopy , psychology , psychotherapist
Objective To quantify the incidence of peripheral neuropathy in gynecologic laparoscopic surgery using a combination of beanbag, eggcrate foam, and shoulder supports; and to assess patient displacement during surgery in a steep Trendelenburg position and determine variables correlated with displacement. Methods A retrospective study included all gynecologic laparoscopic surgeries performed by one high‐volume surgeon at a US center between September 15, 2007, and September 15, 2012. Data included neurologic deficits or extremity pain, any other complications, and—for the final study year—surgical time as well as patient and beanbag displacement. Results Among 967 patients, no long‐term neuropathy was reported, 6 (0.6%) patients had transient shoulder pain beyond the first 24 hours (resolved by initial postoperative visit), and 7 (0.7%) were lost to follow‐up. No neurologic complications were reported. Median beanbag and total patient displacement were 0 cm (interquartile range 0–0) and 0 cm (interquartile range 0–2), respectively. Patient displacement relative to the table was correlated with the total surgical time ( P= 0.025) and patient weight ( P= 0.023). The median displacement was greater in hysterectomy than non‐hysterectomy procedures ( P= 0.003). Conclusion Use of beanbags with shoulder supports and convoluted foam armboard pads was associated with minimal patient displacement and risk of arm and leg neurologic injury.