{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T16:39:57Z","timestamp":1783528797258,"version":"3.55.0"},"reference-count":12,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,9,15]]},"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:p>Brachial plexus injury is a rare but potentially serious complication of laparoscopic surgery. Loss of motor and\/or sensory innervation can have a significant impact on the patient\u2019s quality of life following otherwise successful surgery. A 38-year-old underwent elective laparoscopic management of severe endometriosis during which she was placed in steep head-down tilt Lloyd-Davies position for a prolonged period. On awakening from anaesthesia, the patient had no sensation or movement of her dominant right arm. A total plexus brachialis injury was suspected. As advised by a neurologist, an MRI brachial plexus, nerve conduction study and electromyography were requested. She was managed conservatively and made a gradual recovery with a degree of residual musculocutaneous nerve neuropathy. The incidence of brachial plexus injury following laparoscopy is unknown but the brachial plexus is particularly susceptible to injury as a result of patient positioning and prolonged operative time. Patient positioning in relation to applied clinical anatomy is explored and risk reduction strategies described.<\/jats:p>","DOI":"10.1136\/bcr-2021-243408","type":"journal-article","created":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T09:40:12Z","timestamp":1638178812000},"page":"e243408","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Prolonged brachial plexus neuropathy: a rare complication following protracted endometriosis surgery in Lloyd-Davies position"],"prefix":"10.1136","volume":"14","author":[{"given":"Anna Katrina","family":"Hay","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology, North Middlesex University Hospital NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"McDougall","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, North Middlesex University Hospital NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Hinstridge","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, North Middlesex University Hospital NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjeev","family":"Rajakuldendran","sequence":"additional","affiliation":[{"name":"Neurology, North Middlesex University Hospital NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7286-5968","authenticated-orcid":false,"given":"Wai","family":"Yoong","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, North Middlesex University Hospital NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,11,29]]},"reference":[{"key":"2025082803230190000_14.11.e243408.1","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/S0015-0282(16)56233-5","article-title":"Brachial plexus neuropathies after advanced laparoscopic surgery","volume":"60","author":"Romanowski","year":"1993","journal-title":"Fertil Steril"},{"key":"2025082803230190000_14.11.e243408.2","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.1177\/000313481708301122","article-title":"Peripheral nerve injury during abdominal-pelvic surgery: analysis of the National surgical quality improvement program database","volume":"83","author":"Wallis","year":"2017","journal-title":"Am Surg"},{"key":"2025082803230190000_14.11.e243408.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.07.023"},{"key":"2025082803230190000_14.11.e243408.4","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.jmig.2016.09.004","article-title":"Nerve injuries in gynecologic laparoscopy","volume":"24","author":"Abdalmageed","year":"2017","journal-title":"J Minim Invasive Gynecol"},{"key":"2025082803230190000_14.11.e243408.5","unstructured":"Yoong W , Lodhi W , Govind A . How to perform operative procedures in obstetrics and gynaecology. Wiley\u2010Blackwell, 2020: 136 p."},{"key":"2025082803230190000_14.11.e243408.6","doi-asserted-by":"crossref","DOI":"10.1046\/j.1365-2044.2001.01870-28.x","article-title":"Peripheral nerve injuries associated with anaesthesia","volume":"56","author":"Sawyer","year":"2001","journal-title":"Anaesthesia"},{"key":"2025082803230190000_14.11.e243408.7","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200010000-00010"},{"key":"2025082803230190000_14.11.e243408.8","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1016\/j.jmig.2010.02.010","article-title":"Brachial plexus injury after laparoscopic and robotic surgery","volume":"17","author":"Shveiky","year":"2010","journal-title":"J Minim Invasive Gynecol"},{"key":"2025082803230190000_14.11.e243408.9","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000110542.53489.c6"},{"key":"2025082803230190000_14.11.e243408.10","doi-asserted-by":"crossref","first-page":"478.e1","DOI":"10.1016\/j.ajog.2013.05.037","article-title":"A comparison of shoulder pressure among different patient stabilization techniques","volume":"209","author":"Suozzi","year":"2013","journal-title":"Am J Obstet Gynecol"},{"key":"2025082803230190000_14.11.e243408.11","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/j.jmig.2018.08.027","article-title":"Evaluation of positioning devices for optimization of outcomes in laparoscopic and robotic-assisted gynecologic surgery","volume":"26","author":"Das","year":"2019","journal-title":"J Minim Invasive Gynecol"},{"key":"2025082803230190000_14.11.e243408.12","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.12.9554"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-243408","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:23:10Z","timestamp":1756376590000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-243408"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11]]},"references-count":12,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11,29]]},"published-print":{"date-parts":[[2021,11]]}},"alternative-id":["10.1136\/bcr-2021-243408"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-243408","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11]]}}}