Lower limb compartment syndrome as a complication of laparoscopic laser surgery for severe endometriosis
Carla Tomassetti1, Christel Meuleman, Bernard Vanacker
1Department of Obstetrics and Gynaecology, Leuven University Fertility Centre, University Hospitals Leuven, Leuven, Belgium.
Objective:
To report a case of lower limb compartment syndrome (LLCS) during long duration laparoscopic interventions for resection of extensive endometriosis, and evaluate the efficiency of a novel patient positioning method to reduce its prevalence.
Design:
Case report and observational study.
Setting:
University Hospitals, Belgium.
Patient(S):
Thirty-year-old woman undergoing a long duration laparoscopic intervention for resection of stage IV pelvic endometriosis.
Intervention(S):
Laparoscopic intervention for resection of stage IV pelvic endometriosis.
Main Outcome Measure(S):
The occurrence of LLCS after laparoscopic surgery for extensive endometriosis, in this case, and the prevention of subsequent LLCS after the application of a novel patient positioning method including the following steps: maximal avoidance of the lithotomy position, patient positioning in a modified supine position, mobilization of the legs of the patient in between different surgical phases, and application of intermittent compression stockings.
Result(S):
The prevalence of lower limb compartment syndrome has been reduced to 0 since the application of the new patient positioning method.
Conclusion(S):
Lower limb compartment syndrome can be prevented in patients undergoing long duration multidisciplinary laparoscopic resection of extensive endometriosis by a novel sequential positioning method of patients before and during surgery.
