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Bilateral brachial plexopathy following laparoscopic bariatric surgery
K E J Brunette1, D O Hutchinson, H Ismail
1North Shore Hospital, Waitemata Health, Auckland, New Zealand.
Anaesthesia and Intensive Care
|January 10, 2006
Summary
Postoperative bilateral brachial plexopathy can occur after laparoscopic bariatric surgery. Obese patients in a head-up position without arm support may be at risk for this nerve injury.
Area of Science:
- Neurology
- Surgical Complications
- Obesity Medicine
Background:
- Laparoscopic bariatric surgery is a common procedure for managing morbid obesity.
- Brachial plexopathy is a rare but serious complication that can affect the nerves controlling the arms.
- Patient positioning during surgery is critical to prevent iatrogenic injuries.
Observation:
- A 39-year-old morbidly obese male patient developed bilateral brachial plexopathy after laparoscopic bariatric surgery.
- Symptoms included motor and sensory deficits, loss of reflexes, and bilateral arm pain.
- Neurological deficits manifested postoperatively.
Findings:
- The patient experienced significant motor and sensory impairment in both upper extremities.
- Recovery was slow, with complete resolution of symptoms over a nine-month period.
- The head-up position, common in obese patients undergoing laparoscopic procedures, is implicated.
Implications:
- This case highlights the potential risk of brachial plexus injury in obese patients during laparoscopic bariatric surgery.
- Specific arm support and careful patient positioning are crucial to mitigate this risk.
- Awareness among surgical teams is essential for preventing and managing such neurological complications.
