Nerve injuries w/ hysterectomy

Question 1

What can you do to avoid nerve injuries with a hysterectomy?

Answer 1

Lithotomy position. 2% risk of nerve injury following pelvic surgery. Increased risk injury for surgery <4 hours. If greater time, place pt in supine position for 30 min and then back to lithotomy.

Question 2

What is the saphenous nerve?

Answer 2

Saphenous nerve: branch of femoral nerve (supplies sensation to lower leg).

Can be injured in abdominal and vaginal hysterectomy. Can affect ability to climb stairs.
PREVENT: pad medial aspect of lower leg

Question 3

What is the peroneal nerve?

Answer 3

(common fibular): originates from sciatic nerve. pads lateral lower leg. Presents as foot drop/difficulty dorsiflexing the foot.

Question 4

What is the sciatic nerve?

Answer 4

avoid compression of popliteal fossa
Position hips/knees in comfortable position. Supplies sensation to skin of the foot.

Question 5

What are the Ilioinguinal and genitofemoral nerves?

Answer 5

Originates from L1, L2.

injury causes parathesias of labial and upper thigh. sensory nerves that can be injured with incision. Can compress w/ lateral side wall retractors.

Question 6

What is the Lateral femoral cutaneous nerve?

Answer 6

Originates from L2/L3

Sensory innervation over the anterior thigh.

Question 7

What is the obturator nerve?

Answer 7

Originates from L2-4

sensory innervation of medial thigh and motor innervation of adductor muscles: hip flexion >90 degrees can cause injury. Obturator nerve can be injured during sling. Numbness of inner thigh, minor ambulatory probs

Question 8

What is the Pudendal nerve?

Answer 8

Originates from S2-4
can be injured during SS. No motor function. Sensation → vulvar pain.