Survey of neuromuscular injuries to the patient and surgeon during urologic laparoscopic surgery

J. Stuart Wolf, Robert Marcovich, Inderbir S. Gill, Gyung Tak Sung, Louis R. Kavoussi, Ralph V. Clayman, Elspeth M. McDougall, Arieh Shalhav, Matthew D. Dunn, Jose S. Afane, Robert G. Moore, Raul O. Parra, Howard N. Winfield, R. Ernest Sosa, Roland N. Chen, Michael E. Moran, Stephen Y. Nakada, Blake D. Hamilton, David M. Albala, Fernando KoleskiSakti Das, John B. Adams, Thomas J. Polascik

Research output: Contribution to journalArticle

88 Scopus citations

Abstract

Objectives. Laparoscopy may be complicated by neuromuscular injuries, both to the patient and to the surgeon. We used a survey to estimate the incidence of these injuries during urologic laparoscopic surgery, to assess risk factors for these injuries, and to determine preventive measures. Methods. A survey of neuromuscular injuries associated with laparoscopy submitted to 18 institutions in the United States was completed by 18 attending urologists from 15 institutions. Results. From among a total of 1651 procedures, there were 46 neuromuscular injuries in 45 patients (2.7%), including abdominal wall neuralgia (14), extremity sensory deficit (12), extremity motor deficit (8), clinical rhabdomyolysis (6), shoulder contusion (4), and back spasm (2). Neuromuscular injuries were twice as common with upper retroperitoneal as with pelvic laparoscopy (3.1% versus 1.5%). Among patients with neuromuscular injuries, those with rhabdomyolysis were heavier (means 91 versus 80 kg) and underwent longer procedures (means 379 versus 300 minutes), and those with motor deficits were older (means 51 versus 42 years of age). Of the surgeons, 28% and 17% reported frequent neck and shoulder pain, respectively. Conclusions. Although not common, neuromuscular injuries during laparoscopy do contribute to morbidity. Abdominal wall neuralgias, injuries to peripheral nerves, and joint or back injuries likely occur no more frequently than during open surgery, but risk of rhabdomyolysis may be increased. Positioning in a partial rather than full flank position may reduce the incidence of some injuries. Measures to reduce neuromuscular strain on the surgeon during laparoscopy should be considered. Copyright (C) 2000 Elsevier Science Inc.

Original languageEnglish (US)
Pages (from-to)831-836
Number of pages6
JournalUrology
Volume55
Issue number6
DOIs
StatePublished - Jun 1 2000
Externally publishedYes

ASJC Scopus subject areas

  • Urology

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    Wolf, J. S., Marcovich, R., Gill, I. S., Sung, G. T., Kavoussi, L. R., Clayman, R. V., McDougall, E. M., Shalhav, A., Dunn, M. D., Afane, J. S., Moore, R. G., Parra, R. O., Winfield, H. N., Sosa, R. E., Chen, R. N., Moran, M. E., Nakada, S. Y., Hamilton, B. D., Albala, D. M., ... Polascik, T. J. (2000). Survey of neuromuscular injuries to the patient and surgeon during urologic laparoscopic surgery. Urology, 55(6), 831-836. https://doi.org/10.1016/S0090-4295(00)00488-X