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Diseases of the Colon & Rectum

, Volume 38, Issue 10, pp 1115–1118 | Cite as

Femoral neuropathy secondary to the use of a self-retaining retractor

Report of three cases and review of the literature
  • Robert C. Brasch
  • Anthony J. Bufo
  • Paul F. Kreienberg
  • Garner P. Johnson
Case Reports

Abstract

PURPOSE: Three recent cases of femoral neuropathy at our institution following colorectal surgery have been ascribed to the use of the self-retaining BookwalterTM retractor. The pathophysiology of neural injury includes compression, stretch, transection, ligation, iliopsoas hematoma, ischemia, and cement encapsulation. The Alm of this study is to provide a comprehensive review of femoral nerve anatomy and mechanism of retractor injury. METHODS: The relationship of the femoral nerve to the lateral blade of the BookwaiterTM retractor was evaluated during colorectal surgery and in cadaveric dissections. RESULTS: The lateral blade of the self-retaining retractor was observed to either compress or impinge the intrapelvic portion of the femoral nerve. CONCLUSION: The incidence of postoperative femoral neuropathy is likely underestimated because a majority of cases are self-limited. This debilitating iatrogenic injury can be prevented with a thorough understanding of femoral nerve anatomy and careful placement of self-retaining retractor blades.

Key words

BookwalterTM Retractor Femoral neuropathy 

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Copyright information

© American Society of Colon and Rectal Surgeons 1995

Authors and Affiliations

  • Robert C. Brasch
    • 1
  • Anthony J. Bufo
    • 1
  • Paul F. Kreienberg
    • 1
  • Garner P. Johnson
    • 1
  1. 1.Department of SurgeryAlbany Medical CollegeAlbany

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