Yasin Athar, Patel Ameet G
SHO, General Surgery, Department of Hepato-Biliary & Pancreatic Surgery, King's College Hospital, London, United Kingdom.
Obes Surg. 2007 Jul;17(7):983-5. doi: 10.1007/s11695-007-9155-6.
Iatrogenic nerve injuries have been rarely reported following laparoscopic abdominal surgeries. These can be serious complications with the potential for long-term disability. We present a rare case of bilateral sciatic nerve palsy following laparoscopic sleeve gastrectomy on a super-super-obese male with BMI 78.04 kg/m2. The procedure was completed laparoscopically in 7 hours duration, and in spite of adequate precautions, he developed bilateral sciatic nerve palsy. Nerve conduction studies showed denervation of L5/S1 confirming the diagnosis. The patient showed gradual recovery with physiotherapy, and at 18 months follow-up he was mobilizing without any walking aids, with BMI 47.34 kg/m2. Compressive nerve injuries following prolonged laparoscopic operations should be included in the list of procedural complications, especially in morbidly obese patients where the risk is significantly higher.
医源性神经损伤在腹腔镜腹部手术后鲜有报道。这些可能是严重的并发症,有可能导致长期残疾。我们报告一例罕见的双侧坐骨神经麻痹病例,该病例发生在一名BMI为78.04kg/m²的超级肥胖男性接受腹腔镜袖状胃切除术后。手术通过腹腔镜进行,历时7小时,尽管采取了充分的预防措施,但他仍出现了双侧坐骨神经麻痹。神经传导研究显示L5/S1失神经支配,从而确诊。患者通过物理治疗逐渐康复,在18个月的随访中,他无需任何助行器即可行走,BMI为47.34kg/m²。长时间腹腔镜手术后的压迫性神经损伤应列入手术并发症清单,尤其是在病态肥胖患者中,其风险明显更高。