Anesthesiology and Critical Care

Biography

Biography: Qasem Shehab

Abstract

Nerve injuries are common complications of gynecological surgery, occurring in up
to 2% of cases. Neuropathies can cause considerable postoperative morbidity, as
well as medico- legal implications. Patient mal-positioning, incorrect placement of selfretaining
retractors, hematoma, formation and direct nerve entrapment or transection
is the primary causative factors in perioperative nerve injury. Nerves most commonly
injured during surgery include the femoral, illioinguinal, pudendal, obturator, and lateral
cutaneous, iliohypogastric and genitofemoral nerves. Th e majority of nerve injuries will
have good prognosis, with minimal or no intervention necessary for the resolution of the
neurological impairment. A minority of patients would sustain long term complications
necessitating prolonged treatment or even reparative surgery. Th e role of multidisciplinary
team including surgeon, anesthetist and physiotherapist is of paramount importance, to
improve outcome and decrease morbidities. Involvement of whole theatre team would
result in better outcome and decreasing risk of preventable nerve injury. Th e injuries, although most have good prognosis,
are largely preventable, through proper care in positioning patients for vaginal or endoscopic gynecological surgery. In this
presentation the speaker will outline the anatomy of susceptible nerves, describe common mechanisms of injury and discuss
management of such injuries.