Pressure alopecia following robotic gynaecological surgery: Lessons from a case series on a preventable complication

Pressure alopecia is an under-recognised but preventable post-operative complication associated with surgeries. With the increasing use of robotic gynaecological procedures, patients are often subjected to steep Trendelenburg position predisposing them to scalp pressure and scalp oedema which leads to local ischaemia. We present a case series of patients who developed post-operative pressure alopecia following robotic gynaecological surgery. All cases were characterised by delayed onset, non-scarring alopecia over pressure-bearing areas of the scalp, with spontaneous regrowth over time. Although benign, this complication can cause significant patient distress and dissatisfaction especially in young female patients. This case series aims to create awareness among anaesthesiologists and surgical teams regarding this preventable complication. Simple preventive measures such as appropriate head padding, periodic head repositioning when feasible, minimising operative duration, and heightened intraoperative vigilance can significantly reduce its occurrence. Increased awareness and incorporation of preventive strategies into routine perioperative care can help avoid this avoidable complication.