Patient Positioning for Operative Laparoscopy in Pediatric and Adolescent Gynecologic Surgery

Purposeful positioning of the pediatric and adolescent patient is critical for successful operative laparoscopy as it facilitates visualization of the abdominopelvic anatomy, optimizes anatomic mobilization, and decreases operative time. For diagnosis and treatment of endometriosis, dorsal lithotomy positioning with modified Trendelenburg is often preferred. Despite the appreciable benefit of this positioning during these operations, there is an inherent risk of iatrogenic injury secondary to nerve compression and decreased compartment perfusion. Care must be taken to minimize these risks during every operation to avoid nerve injury and compartment syndrome. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

Bruzoni M, Albanese C. Minimal access pediatric surgery. In: Nezhat’s video-assisted and robotic-assisted laparoscopy and hysteroscopy with DVD. 4th ed. New York: Cambridge University Press; 2013. Hill-Rom. Allen medical, Allen stirrups, instructional video [Internet]. [Cited 2019 Feb 27]. Available from: https://www.youtube.com/watch?v=fudU0yo_VG8. Tomassetti C, Meuleman C, Vanacker B, D’Hooghe T. Lower limb compartment syndrome as a complication of laparoscopic laser surgery for severe endometriosis. Fertil Steril. 2009;92(6):2038.e9–12. Casey J, Yunker A, Anderson T. Gynecologic surgery in the pediatric and adolescent populations: review of perioperative and operative considerations. J Minim Invasive Gynecol. 2016;23(7):1033–9. Abdalmageed OS, Bedaiwy MA, Falcone T. Nerve injuries in gynecologic laparoscopy. J Minim Invasive Gynecol. 2017;24(1):16–27. Frezza EE. The lithotomy versus the supine position for laparoscopic advanced surgeries: a historical review. J Laparoendosc Adv Surg Tech. 2005;15(2):140–4. Burlingame BL. Guideline implementation: positioning the patient. AORN J. 2017;106(3):227–37. Stornelli N, Wydra FB, Mitchell JJ, Stahel PF, Fabbri S. The dangers of lithotomy positioning in the operating room: case report of bilateral lower extremity compartment syndrome after a 90-minutes surgical procedure. Patient Saf Surg. 2016;10. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4960854/. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Electronic Supplementary Material With use of uterine manipulator during laparoscopy, the position of the uterus can be mobilized facilitating evaluation of the deep pelvis for endometriotic lesions and further treatment (MP4 121271 kb) Rights and permissions Copyright information © 2020 Springer Nature Switzerland AG About this chapter Cite this chapter Ponsky, T.A., Hanke, R.E., Casar Berazaluce, A.M., Breech, L.L. (2020). Patient Positioning for Operative Laparoscopy in Pediatric and Adolescent Gynecologic Surgery. In: Nezhat, C.H. (eds) Endometriosis in Adolescents. Springer, Cham. https://doi.org/10.1007/978-3-030-52984-0_33 Download citation DOI: https://doi.org/10.1007/978-3-030-52984-0_33 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-030-52983-3 Online ISBN: 978-3-030-52984-0 eBook Packages: MedicineMedicine (R0)