Lower limb compartment syndrome as a complication of laparoscopic laser surgery for severe endometriosis

Fertil Steril. 2009 Dec;92(6):2038.e9-12. doi: 10.1016/j.fertnstert.2009.07.1661.

Abstract

Objective: To report a case of lower limb compartment syndrome (LLCS) during long duration laparoscopic interventions for resection of extensive endometriosis, and evaluate the efficiency of a novel patient positioning method to reduce its prevalence.

Design: Case report and observational study.

Setting: University Hospitals, Belgium.

Patient(s): Thirty-year-old woman undergoing a long duration laparoscopic intervention for resection of stage IV pelvic endometriosis.

Intervention(s): Laparoscopic intervention for resection of stage IV pelvic endometriosis.

Main outcome measure(s): The occurrence of LLCS after laparoscopic surgery for extensive endometriosis, in this case, and the prevention of subsequent LLCS after the application of a novel patient positioning method including the following steps: maximal avoidance of the lithotomy position, patient positioning in a modified supine position, mobilization of the legs of the patient in between different surgical phases, and application of intermittent compression stockings.

Result(s): The prevalence of lower limb compartment syndrome has been reduced to 0 since the application of the new patient positioning method.

Conclusion(s): Lower limb compartment syndrome can be prevented in patients undergoing long duration multidisciplinary laparoscopic resection of extensive endometriosis by a novel sequential positioning method of patients before and during surgery.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Compartment Syndromes / epidemiology
  • Compartment Syndromes / etiology*
  • Compartment Syndromes / prevention & control*
  • Endometriosis / epidemiology
  • Endometriosis / surgery*
  • Female
  • Humans
  • Laparoscopy / adverse effects*
  • Laparoscopy / methods
  • Laparoscopy / statistics & numerical data
  • Laser Therapy / adverse effects
  • Laser Therapy / methods
  • Laser Therapy / statistics & numerical data
  • Leg
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology*
  • Postoperative Complications / prevention & control*
  • Posture
  • Practice Guidelines as Topic
  • Prevalence
  • Severity of Illness Index
  • Stockings, Compression