The incidence of peripheral nerve injuries related to patient positioning during roboticassisted surgery: An evidence summary

Objective: To describe the incidence and anatomical locations of peripheral nerve injuries (PNIs) related to patient positioning during urologic, gynaecologic and colorectal robotic-assisted surgery (RAS). Background: Incorrect positioning of extremities and lack of assistive devices in steep Tr...

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Main Authors: Tina Oblak, Brigid Gillespie
Format: Article
Language:English
Published: Australian College of Perioperative Nurses 2021-11-01
Series:Journal of Perioperative Nursing
Subjects:
Online Access:https://journal.acorn.org.au/index.php/jpn/article/view/182
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author Tina Oblak
Brigid Gillespie
author_facet Tina Oblak
Brigid Gillespie
author_sort Tina Oblak
collection DOAJ
description Objective: To describe the incidence and anatomical locations of peripheral nerve injuries (PNIs) related to patient positioning during urologic, gynaecologic and colorectal robotic-assisted surgery (RAS). Background: Incorrect positioning of extremities and lack of assistive devices in steep Trendelenburg (up to 45°) positioning during urologic, gynaecologic and colorectal RAS places the patient at potential risk of nerve injury. Method: A structured search of recent systematic reviews published between January 2019 and August 2021 in the Cochrane Library, PubMed, ProQuest and Google Scholar databases using search terms ‘patient positioning’, ‘roboticassisted surgery’, ‘Trendelenburg’, ‘complication’ and ‘injury’ with medical subject headings (MeSH) was conducted. Results: The overall incidence rates of PNI associated with patient positioning during RAS varied from 0.16 to 10.8 per cent. The most common anatomical positions of nerve injuries in upper extremities related to patient positioning during RAS were identified in brachial plexus, ulnar, median, radial and humeral nerves. For lower extremities, nerve injuries were identified in the sciatic, femoral, obturator, femoral cutaneous and common cutaneous nerves. Conclusion: Operating room teams should develop institutional policies to support perioperative practice that is based on the best available evidence. Application: This evidence summary supports the need for frequent routine checks and constant monitoring of the patient’s position through the operating procedure.
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spelling doaj-art-1fb31e6b84b64d41a40a5455cc86f94a2025-08-20T03:13:46ZengAustralian College of Perioperative NursesJournal of Perioperative Nursing2209-10842209-10922021-11-0134410.26550/2209-1092.1166The incidence of peripheral nerve injuries related to patient positioning during roboticassisted surgery: An evidence summaryTina Oblak0Brigid Gillespie1Ljubljana University Medical CentreGriffith University, Gold Coast Hospital & Health Service Objective: To describe the incidence and anatomical locations of peripheral nerve injuries (PNIs) related to patient positioning during urologic, gynaecologic and colorectal robotic-assisted surgery (RAS). Background: Incorrect positioning of extremities and lack of assistive devices in steep Trendelenburg (up to 45°) positioning during urologic, gynaecologic and colorectal RAS places the patient at potential risk of nerve injury. Method: A structured search of recent systematic reviews published between January 2019 and August 2021 in the Cochrane Library, PubMed, ProQuest and Google Scholar databases using search terms ‘patient positioning’, ‘roboticassisted surgery’, ‘Trendelenburg’, ‘complication’ and ‘injury’ with medical subject headings (MeSH) was conducted. Results: The overall incidence rates of PNI associated with patient positioning during RAS varied from 0.16 to 10.8 per cent. The most common anatomical positions of nerve injuries in upper extremities related to patient positioning during RAS were identified in brachial plexus, ulnar, median, radial and humeral nerves. For lower extremities, nerve injuries were identified in the sciatic, femoral, obturator, femoral cutaneous and common cutaneous nerves. Conclusion: Operating room teams should develop institutional policies to support perioperative practice that is based on the best available evidence. Application: This evidence summary supports the need for frequent routine checks and constant monitoring of the patient’s position through the operating procedure. https://journal.acorn.org.au/index.php/jpn/article/view/182steep Trendelenburgassistive devicesintra-operative complicationspatient positioningpatient monitoring
spellingShingle Tina Oblak
Brigid Gillespie
The incidence of peripheral nerve injuries related to patient positioning during roboticassisted surgery: An evidence summary
Journal of Perioperative Nursing
steep Trendelenburg
assistive devices
intra-operative complications
patient positioning
patient monitoring
title The incidence of peripheral nerve injuries related to patient positioning during roboticassisted surgery: An evidence summary
title_full The incidence of peripheral nerve injuries related to patient positioning during roboticassisted surgery: An evidence summary
title_fullStr The incidence of peripheral nerve injuries related to patient positioning during roboticassisted surgery: An evidence summary
title_full_unstemmed The incidence of peripheral nerve injuries related to patient positioning during roboticassisted surgery: An evidence summary
title_short The incidence of peripheral nerve injuries related to patient positioning during roboticassisted surgery: An evidence summary
title_sort incidence of peripheral nerve injuries related to patient positioning during roboticassisted surgery an evidence summary
topic steep Trendelenburg
assistive devices
intra-operative complications
patient positioning
patient monitoring
url https://journal.acorn.org.au/index.php/jpn/article/view/182
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AT tinaoblak incidenceofperipheralnerveinjuriesrelatedtopatientpositioningduringroboticassistedsurgeryanevidencesummary
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