Brachial plexus injury after laparoscopic and robotic surgery

Area of Science:

• Gynecologic Surgery
• Surgical Complications
• Neurology

Background:

• Brachial plexus injury (BPI) is an uncommon but serious complication in gynecologic surgery.
• The incidence of BPI in laparoscopic gynecologic surgery is approximately 0.16%.
• Increased utilization of advanced laparoscopic and robotic procedures may lead to a higher risk of BPI.

Purpose of the Study:

• To review the existing literature on brachial plexus injury (BPI) in the context of laparoscopic and robotic gynecologic surgery.
• To discuss the anatomy, pathophysiology, diagnosis, and treatment of position-related BPI.
• To provide recommendations for the prevention of BPI in these surgical settings.

Main Methods:

• Literature review of studies concerning brachial plexus injury in laparoscopic and robotic gynecologic surgery.
• Analysis of anatomical and pathophysiological factors contributing to BPI.
• Synthesis of current diagnostic and treatment strategies.

Main Results:

• Robotic surgery may involve steeper Trendelenburg positioning and longer operative durations compared to traditional laparoscopy, potentially increasing BPI risk.
• A multidisciplinary approach is recommended for the diagnosis and management of BPI.
• Preventive measures are essential to mitigate the risk of position-related BPI.

Conclusions:

• Position-related brachial plexus injury is a recognized complication in gynecologic laparoscopic and robotic surgery.
• Early recognition, appropriate management, and proactive prevention strategies are vital.
• Further research may be needed to fully elucidate risk factors and optimal prevention techniques.