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Surgical Approach and Complications of Stand-alone Lateral Trans-Psoas Interbody Fusion
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Risk Factors and Preventive Measures for Well-Leg Compartment Syndrome During Minimally Invasive Surgery in the

Tomoya Miura1, Jun Watanabe2,3,4, Shingo Tsujinaka1

  • 1Division of Gastroenterologic Surgery, Department of Surgery, Tohoku Medical and Pharmaceutical University, Sendai 983-8536, Miyagi, Japan.

Journal of Clinical Medicine
|June 12, 2026
PubMed
Summary

Well-leg compartment syndrome is a rare surgical risk. This review identifies key risk factors and preventive measures for minimally invasive surgery, highlighting the need for further research and standardized guidelines.

Keywords:
compartment syndromesintraoperativelaparoscopylithotomy positionmonitoringperioperative carerisk factorsrobotic surgical procedureswell-leg compartment syndrome

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Published on: May 31, 2019

Area of Science:

  • Surgical Complications
  • Minimally Invasive Surgery
  • Compartment Syndrome

Background:

  • Well-leg compartment syndrome is a rare but serious complication of the lithotomy position during pelvic surgery.
  • Previous research focused on open surgery; comprehensive reviews on minimally invasive approaches are lacking.

Purpose of the Study:

  • To summarize current evidence on well-leg compartment syndrome in minimally invasive surgery.
  • To identify associated risk factors and evaluate prevention strategies.

Main Methods:

  • A scoping review following PRISMA-ScR guidelines.
  • Literature search across MEDLINE, Embase, and CENTRAL databases.
  • Data extraction from studies involving minimally invasive surgery in the lithotomy position.

Main Results:

  • 25 studies (cohorts, case reports) were included.
  • Prolonged operative time (>4 hours) and gastrointestinal procedures were common.
  • Risk factors include high BMI, large calf circumference, PVD, and specific surgical positions. Fasciotomy was frequently required.

Conclusions:

  • Key risk factors and preventive measures for compartment syndrome in minimally invasive surgery were identified.
  • Evidence specific to minimally invasive surgery is limited, and standardized guidelines are absent.
  • Multicenter studies are necessary to establish optimal preventive strategies and enhance patient safety.