A Case of Posterior Interosseous Nerve Palsy Associated With Robotic Low Anterior Resection

A peripheral nerve compression injury associated with surgical positioning is an important complication that might compromise quality of life. We report a rare case of posterior interosseous nerve (PIN) palsy after robotic rectal cancer surgery. A 79-year-old male with rectal cancer underwent robotic low anterior resection in a modified lithotomy position with both arms tucked at his sides with bed sheets. Following surgery, he felt difficulty moving his right wrist and fingers. A neurological examination revealed muscle weakness in the area innervated by the PIN alone without sensory disturbance, and he was diagnosed with PIN palsy. The symptoms improved with conservative treatment in about a month. The PIN is a branch of the radial nerve and controls dorsiflexion of the fingers, and intraoperative continuous pressure on the upper arm by right lateral rotation position or by the robot arm was considered to be the cause.