![]() The exaggerated lithotomy position for radical prostatectomy may be associated with a high risk of neuromuscular complications due to prolonged flexion and abduction of the patient’s legs, with increased risk of sciatic nerve stretching.Ībnormal positioning of the lower limb during the lithotomy position may result in lower limb compartment syndrome, which is different from that caused by trauma or direct injury, and presents with extreme postoperative and unusual leg pain. It has been observed that application of shoulder braces in combination with a steep Trendelenburg position may be associated with brachial plexus injuries. Overstretching of the brachial plexus typically resulted from extended arm abduction, external rotation, and/or posterior shoulder displacement, either in the supine or flank positions. The peroneal nerve may be injured due to compression of the lower leg against the table, while the obturator nerve may be injured during pelvic lymph node dissection (Fig. Higher skin pressure was also observed with the use of full flank position and elevation of the kidney rest. In addition, the pressure generated at the skin-to-table surface interface was increased in patients with a body mass index (BMI) greater than 25 kg/m 2, independent of gender. These complications are exacerbated by prolonged operative time, especially when the patient is in direct contact with an unpadded table. The modified or full flank position may be associated with various neuromuscular complications, including upper and lower extremity neural stretch injuries such as sciatic nerve injury, paresthesia, numbness, rhabdomyolysis of the thigh, and paraspinous muscle pain. ![]()
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