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Brachial plexopathy in laparoscopic-assisted rectal surgery: a case series
J Eteuati1, R Hiscock, I Hastie
1Colorectal Unit, Royal Melbourne Hospital, Grattan Street, Parkville, VIC, 3050, Australia. jimmyeteuati@yahoo.com.au
Techniques in Coloproctology
|November 29, 2012
Summary
Brachial plexopathy, a nerve injury, can occur during laparoscopic colorectal surgery despite precautions. Careful patient positioning and monitoring are crucial to minimize this preventable complication.
Area of Science:
- Surgical safety and patient outcomes.
- Anesthesiology and nerve injury prevention.
- Colorectal surgery best practices.
Background:
- Brachial plexopathy is a known risk in anesthesia due to patient malpositioning.
- It is the second most common nerve injury in anesthetized patients.
- Incidence in colorectal surgery is not well-defined, but cases are reported.
Observation:
- Five cases of brachial plexopathy occurred despite preventative measures in 548 laparoscopic colorectal resections.
- The likely cause was nerve stretch.
- All patients recovered, with full resolution taking up to 7 months.
Findings:
- The incidence of brachial plexopathy in this series was approximately 1%.
- Nerve injury may still occur even with careful positioning and monitoring.
- The condition is likely under-reported in laparoscopic colorectal surgery.
Implications:
- Awareness of predisposing and perioperative factors is essential for laparoscopic colorectal procedures.
- Implementing specific precautionary steps can help minimize brachial plexopathy.
- This preventable morbidity requires further attention in surgical safety protocols.
