[On the prevention of paresis of the femoral nerve following abdominal gynaecological operations (author's transl)].

Self retaining retractors may cause paresis of the femoral nerve following abdominal gynaecological operation. In principle all types of retractors may be the cause. Self retaining retractors with small and long lateral blades are especially dangerous. The paresis is caused by direct and indirect pressure of the lateral blades of the retractor on the nerve. The discrepancy between large and deep retractor blades and thin abdominal walls predisposes to paresis of the femoral nerve. Thin underweight patients are especially in danger. In addition, a transverse incision, too much tension and a long duration of the operation are predisposing factors. The prevention is possible by knowledge of the case and a careful selection of the lateral blades of the retractor in accordance with the individual anatomy encountered. Sometimes manual retractors have to be used instead of a self retaining retractor.