scholarly journals Femoral nerve injury in gynecologic surgery: medico-legal issues for best surgical practices

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Piergiorgio Fedeli ◽  
Maurizio Guida ◽  
Pasquale Giugliano ◽  
Laura Letizia Mazzarelli ◽  
Annalisa D’Apuzzo ◽  
...  
Keyword(s):  
Nerve Injury ◽  
Femoral Nerve ◽  
Gynecologic Surgery ◽  
Motor Deficits ◽  
Lithotomy Position ◽  
Malpractice Claims ◽  
Surgical Data ◽  
Legal Expert ◽  
Femoral Nerve Injury ◽  
Medical Malpractice Claims

Abstract Background Femoral nerve injury following gynecologic surgery may be a postoperative complication, leading to medical malpractice claims and litigation. Methods and results A retrospective analysis was performed on data collected from 973 medico-legal reports of suspected malpractice in gynecologic surgery, filed with the Italian Court between 2000 and 2010. Twelve cases were selected for proven negligence, after a blinded investigation conducted by a gynecologist and a medico-legal expert. Surgical data included type of procedure (hysterectomy, salpingectomy, cesarean section, endometriosis excision), duration of procedure, patient position, and use of retractors. For each case, the observed neuropathy, degree of severity, and recovery time after physical therapy were described. Neuropathies were classified into three categories: neuropraxia (three cases), axonotmesis (six cases), and neurotmesis (three cases) with high sensory and motor deficits. Many particular conditions and pre-existing comorbidity were observed. Two neuropraxia cases were associated with the lithotomy position; axonotmesis cases were related to the incorrect use of self-retaining retractors and an inadequate lithotomy position. Conclusions To avoid potential malpractice lawsuits, care must be taken to accurately collect data linked to individual factors and the possible complications of a surgical procedure. A detailed description is required of the patient’s position on the surgical table, the self-retaining retractors selected, length of time they were in use, maximum tractive force exerted, and their inspection or repositioning during the operation.

Femoral Nerve Injury Complicating Surgery for Gynecologic Cancer

2014 ◽  
Vol 24 (6) ◽  
pp. 1112-1117 ◽  
Author(s):  
Francesco Maneschi ◽  
Roberta Nale ◽  
Roberto Tozzi ◽  
Desiree Biccirè ◽  
Seila Perrone ◽  
...  
Keyword(s):  
Nerve Injury ◽  
Gynecologic Cancer ◽  
Femoral Nerve ◽  
Injury Rate ◽  
Pelvic Lymphadenectomy ◽  
Cancer Surgery ◽  
Gynecologic Surgery ◽  
Muscle Shortening ◽  
Femoral Nerve Injury ◽  
Second Period

ObjectiveThe aim of this study was to report the incidence, severity, and factors associated with femoral nerve injury during gynecologic cancer surgery.MethodsAll patients who underwent abdominal surgery for gynecologic cancer entered the study. A retrospective review of the medical records was carried out for patients operated on from 2003 to April 2011. After this analysis, the use of the Bookwalter retractor was modified and the data were prospectively recorded.ResultsIn the first period, femoral nerve injury was observed in 11 (2.7%) of 406 patients, occurring with a significantly higher frequency when the Bookwalter retractor was used (5.1% vs 0%,P< 0.01) and when pelvic lymphadenectomy was performed (5.1% vs 0.9%,P< 0.01). The analysis of the 212 patients (52.2%) in the Bookwalter group showed higher frequency of nerve injury in the patients undergoing pelvic lymphadenectomy (7.8% vs 2.0%,P= 0.05). In the second period, femoral nerve injury was observed in 1 (0.7%) of 132 patients operated on and in 1 (2.3%) of 43 patients (32.6%) in the Bookwalter group. When comparing the 2 periods, the lesser use of the Bookwalter retractor and the reduced time of maximal traction of the pelvic blades decreased the nerve injury rate from 2.7% to 0.7% and, in the Bookwalter group, from 5.1% to 2.3%. These results, although not statistically significant, are clinically relevant.ConclusionsFemoral nerve injury during gynecologic cancer surgery was associated with the Bookwalter retractor. The pelvic blades of the retractor may exert a compression on the nerve. The weakened muscles suggest that the nerve compression occurred intrapelvically over the iliacus muscle. Shortening the time of maximal traction of the pelvic blades reduced the incidence of femoral nerve injury. When performing gynecologic surgery with the use of the Bookwalter retractor, care must taken with the placement of the pelvic blades.

scholarly journals Femoral nerve injury due to interventional angiographic procedures

2019 ◽  
Vol 25 (3) ◽  
pp. 181-183
Author(s):  
Buket Tuğan Yıldız ◽  
Mustafa Gökçe ◽  
Deniz Tuncel ◽  
Hamza Şahin ◽  
Muhammet Yusuf Uslusoy
Keyword(s):  
Nerve Injury ◽  
Femoral Nerve ◽  
Femoral Nerve Injury

Femoral Nerve Injury After Gynecologic Laparoscopy

2008 ◽  
Vol 15 (1) ◽  
pp. 105-107 ◽  
Author(s):  
Andrea Porzionato ◽  
Veronica Macchi ◽  
Fabio Fenato ◽  
Anna Parenti ◽  
Raffaele De Caro
Keyword(s):  
Nerve Injury ◽  
Femoral Nerve ◽  
Gynecologic Laparoscopy ◽  
Femoral Nerve Injury

Sciatic and femoral nerve injury among patients who received Bernese peri-acetabular osteotomy

2018 ◽  
Vol 43 (3) ◽  
pp. 573-577 ◽  
Author(s):  
Jinxin Yang ◽  
Zhendong Zhang ◽  
Hui Cheng ◽  
Kai Xiao ◽  
Dianzhong Luo ◽  
...  
Keyword(s):  
Nerve Injury ◽  
Femoral Nerve ◽  
Femoral Nerve Injury

scholarly journals Giant recurrent left inguinal hernia with femoral nerve injury: a report of a rare case

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Manzhou Lin ◽  
Guojie Long ◽  
Ming Chen ◽  
Weice Chen ◽  
Jian Mo ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Nerve Injury ◽  
Rare Case ◽  
Femoral Nerve ◽  
Femoral Nerve Injury

scholarly journals Series of Cases with Iatrogenic Nerve Injury

1970 ◽  
Vol 28 (2) ◽  
pp. 121-124
Author(s):  
Selina Daisy ◽  
Quazi Deen Mohammad ◽  
Azharul Hoque ◽  
Badrul Alam ◽  
Badrul Haque ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Peripheral Nerve ◽  
Nerve Injury ◽  
Femoral Nerve ◽  
Accessory Nerve ◽  
Nerve Injuries ◽  
Sacral Plexus ◽  
Iatrogenic Injuries ◽  
Iatrogenic Nerve Injury ◽  
Femoral Nerve Injury

After introduction of EMG at Dhaka Medical Collage onJanuary 01, 2006, a total of 415 cases referred to EMGlaboratory for electrophysiological evaluation over a periodof two years(January 01, 2006 to December 31, 2007). Among these, 7cases diagnosed as iatrogenic nerve injuries. The subtypesof iatrogenic nerve injuries were:1. Accessory nerve injury: three, 2. Femoral nerve injury:one, 3. Sciatic nerve injury: one,4. Lumbar sacral plexus injury: one, 5. Combined sciaticand femoral nerve injury: oneIn order to investigate the causes, diagnosis & preventionof iatrogenic nerve injuries; we have reviewed 7 cases ofiatrogenic nerve injuries. The peripheral nerve injuriesoccurred due to lack of proper awareness of medicalpersonals. These injuries are iatrogenic injuries so it isuseful to review the mode of injuries and means ofprevention.DOI: 10.3329/jbcps.v28i2.5373J Bangladesh Coll Phys Surg 2010; 28: 121-124

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