menu

800.225.2610

Rise in robotic surgeries may lead to more nerve injuries

May 18, 2015
nerve injuries

The number of laparoscopic and robotic surgeries has increased dramatically over the past few decades. While these surgeries offer benefits such as smaller incisions and decreased blood loss, they are not without risk. The procedures often require steeper Trendelenburg positioning and longer operating times, which can lead to brachial plexus and other nerve injuries

Normally, the brachial plexus is protected from injury by the surrounding bones in the shoulder. However, Trendelenburg positioning during surgery can leave the area vulnerable. Although relatively uncommon, with an incidence of 0.16%, the risk of surgical-related brachial plexus injury should not be downplayed. These patient injuries have been shown to cause significant postoperative morbidity and can have serious legal implications. In some parts of the world, a disproportionately large number of malpractice claims against obstetricians derive from such injuries.

Position to Protect

Fortunately, the incidence of brachial plexus injuries may be reduced through careful attention to patient positioning. In fact, the majority of these types of injuries can be directly attributed to improper or inadequate patient positioning.

According to the Association of Surgical Technologies (AST), proper positioning should start with a comprehensive patient assessment. The assessment should include age, weight, height, skin integrity, range of motion and pre-existing conditions. The AST, as well as several clinical studies, also stresses the importance of patient positioning devices. Recommendations include using a patient positioner that does not require shoulder braces, but does incorporate ample gel-based padding to redistribute pressure and minimize slipping. In addition, protective padding on the arm board and limiting arm abduction to 90 degrees have been highlighted in other studies as valuable protective features.

The risk of brachial plexus injury during surgery may be small, but the consequences may not be. An easy-to-use Trendelenburg positioner that reduces focal pressure and minimizes slipping may be the key to making that risk even lower.

Disclaimer

AliMed, Inc. is a manufacturer and distributor of medical supply products, and is not a medical authority. The contents contained in this article, including text, graphics, imagery, and other materials, are for informational and educational purposes only. AliMed does not provide or intend to provide medical advice, diagnosis, or treatment, and the information contained here should not be treated as such. If you have questions about a specific medical condition or specific personal use of a medical device, always consult your physician or other qualified healthcare provider.

Although every effort has been made to present information that is accurate and true to the best of our knowledge, this content may contain omissions or errors. AliMed does not regularly update information or resources for this content and does not guarantee, make any warranties, and accepts no liability for the accuracy or completeness of the information presented.