Abstract
OBJECTIVE: The purpose of this “tip and tricks” is to review steps to minimize brachial plexus injury during robotic pelvic reconstructive surgery. DESCRIPTION: In this presentation we outline the incidence, mechanism of injury and risk factors for brachial plexus injury during laparoscopic surgery. We also discuss risk factors uniquely associated with robotic surgery. We present a model to measure pressures applied to the shoulder region as a function of steep Trendelenburg positioning. Steps to minimize brachial plexus stretch injury are reviewed. CONCLUSION: Awareness of potential for nerve injury and application of several preventive measures may improve patient safety during robotic pelvic surgery.
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