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Rhabdomyolyse et syndrome des loges des deux avant-bras lors d’une chirurgie robotique de longue durée
Authors:P. Deras  J. Amraoui  C. Boutin  S. Laporte  J. Ripart
Affiliation:1. Division anesthésie–réanimation–douleur–urgence, faculté de médecine Montpellier–Nîmes, université Montpellier 1, CHU de Nîmes, place du Professeur-Robert-Debré, 30029 Nîmes cedex 9, France;2. Département de chirurgie digestive, CHU de Nîmes, place du Professeur-Robert-Debré, 30029 Nîmes cedex 9, France
Abstract:
Robotic assisted laparoscopic surgery allows for a more precise dissection than classical laparoscopic surgery. However, it sometimes imposes specific exaggerated postures and extralong procedure duration. Combining these two factors may increase the risk for postural complications in at-risk patients. We report the case of an obese 30-year-old female patient who underwent a 12-hour duration robotic laparoscopic surgery for severe endometriosis, in Trendelenburg position. This was complicated by a two forearms rhabdomyolysis, with subsequent compartment syndrome with multiple neuropathy. Physicians must be aware of the cumulative risk for postural complications when extreme positions are associated to long duration procedures in predisposed patients.
Keywords:Posture chirurgicale   Rhabdomyolyse   Syndrome de loge   Neuropathie pé  riphé  rique postopé  ratoire   Chirurgie assisté  e par robot
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