Brachial plexus injury after a left-side modified radical mastectomy associated with patient positioning in the operating room

Gineco eu ◽  
2013 ◽  
Vol 9 (3) ◽  
pp. 136-137
Author(s):  
Cristian D.A.
2021 ◽  
Vol 14 (11) ◽  
pp. e243408
Author(s):  
Anna Katrina Hay ◽  
Anna McDougall ◽  
Peter Hinstridge ◽  
Sanjeev Rajakuldendran ◽  
Wai Yoong

Brachial plexus injury is a rare but potentially serious complication of laparoscopic surgery. Loss of motor and/or sensory innervation can have a significant impact on the patient’s quality of life following otherwise successful surgery. A 38-year-old underwent elective laparoscopic management of severe endometriosis during which she was placed in steep head-down tilt Lloyd-Davies position for a prolonged period. On awakening from anaesthesia, the patient had no sensation or movement of her dominant right arm. A total plexus brachialis injury was suspected. As advised by a neurologist, an MRI brachial plexus, nerve conduction study and electromyography were requested. She was managed conservatively and made a gradual recovery with a degree of residual musculocutaneous nerve neuropathy. The incidence of brachial plexus injury following laparoscopy is unknown but the brachial plexus is particularly susceptible to injury as a result of patient positioning and prolonged operative time. Patient positioning in relation to applied clinical anatomy is explored and risk reduction strategies described.


2007 ◽  
Vol 18 (7) ◽  
pp. 833-834 ◽  
Author(s):  
Anil Kumar Pillai ◽  
Hector Ferral ◽  
Sudhen Desai ◽  
Sudheer Paruchuri ◽  
Scott Asselmeier ◽  
...  

2010 ◽  
Vol 13 (4) ◽  
pp. 552-558 ◽  
Author(s):  
Juan S. Uribe ◽  
Jaya Kolla ◽  
Hesham Omar ◽  
Elias Dakwar ◽  
Naomi Abel ◽  
...  

Object In the present study, the authors identified the etiology, precipitating factors, and outcomes of perioperative brachial plexus injuries following spine surgery. Methods We reviewed all the available literature regarding postoperative/perioperative brachial plexus injuries, with special concern for the patient's position during surgery, duration of surgery, the procedure performed, neurological outcome, and prognosis. We also reviewed the utility of intraoperative electrophysiological monitoring for prevention of these complications. Results Patient malpositioning during surgery is the main determining factor for the development of postoperative brachial plexus injury. Recovery occurs in the majority of cases but may require weeks to months of therapy after initial presentation. Conclusion Brachial plexus injuries are an increasingly recognized complication following spinal surgery. Proper attention to patient positioning with the use of intraoperative electrophysiological monitoring techniques could minimize injury.


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