Sandeep S Sandhu, Samhita Mallavarapu and Shannon M Smith and Maurice M Garcia*
Published on: 21st November, 2023
Purpose: Lower-extremity (LE) injuries due to prolonged surgery duration in the dorsal lithotomy (DL) position are often morbid and can significantly affect the patient’s short and long-term quality of life. These include the development of lower extremity pressure ulcers, neuropathies, rhabdomyolysis, and compartment syndromes. As compared to other surgeries, this risk is increased in patients undergoing genital gender-affirming surgery (gGAS) due to the relatively long operative time of these surgeries related to their high complexity. Our study aimed to describe our technique for preventing LE injuries in the DL position, and to evaluate our positioning-related post-operative complications and rates.Materials and Methods: We describe our technique for positioning in the dorsal lithotomy position, with an emphasis on injury prevention. We ensure a specific padding technique of the LE, we alert surgical assistants to not lean/rest on the LE, and we schedule LE checks and repositioning throughout the case to prevent and mitigate occult injuries. Herein, we report our clinical positioning-related outcomes and complications among all patients undergoing gGAS procedures lasting >300 minutes between January 2017 to March 2023. Results: A total of 227 patients underwent 310 surgical procedures (156 masculinizing, 154 feminizing gGAS procedures). Mean operative time was 495.5 minutes+/-156.5 minutes (SD) (Range 300–1095 minutes). A total of 6/227 (2.6%) patients (2 masculinizing and 4 feminizing surgical patients) had transient, self-limited LE pain post-op. No (0%) patients had major complications including chronic nerve injury, pressure ulcers, rhabdomyolysis, or compartment syndrome.Conclusions: Our study is the first to describe a replicable technique, and specifically which integrates the OR team and nursing staff, to prevent LE injuries during DL. We show that it is possible to achieve a 0%-to-rare incidence of major LE injury during long-duration surgeries.
I wanna to thank Clinical Journal of Nursing Care and Practice for its effort to review and publish my manuscript. This is reputable journal. Thank you!
Atsedemariam Andualem
I hope to ability to make some new investigation and publish in Your Company in future.
Artur Stopyra
"This is my first time publishing with the journal/publisher. I am impressed at the promptness of the publishing staff and the professionalism displayed. Thank you for encouraging young researchers li...
Ajite Kayode
I think that Heighpubs very good. You are very helpful. Thank you for everything.
Ana Ribeiro
Thanks you and your colleague for the great help for our publication. You always provide prompt responses and high quality of service. I am so happy to have you working with me.
Thanks again!
Diana (Ding) Dai
It was a real pleasure working with your team. The review was done fast, and it was very clear, the editing was flawless, the article was published quickly compared to other journals, and everyone w...
Alexandra Cozma
Thank you very much. I think the review process and all of what concerns the administration of the publication concerning our paper has been excellent. The nice and quick answers have been very good I...
Doris Nilsson
“The choice to submit the forensic case study to the Journal of Addiction Therapy and Research was dictated by the match between the content and the potential readership. The publication process pro...
Elisabeth H Wiig
Once I submitted the manuscript, the response time of the reviewers was very fast. The fine-tuning of the galley proof was likewise prompt. I believe the journal provide a valuable outlet to dissemina...
Alon
We thank to the heighten science family, who speed up the publication of our article and provide every support.
HSPI: We're glad you're here. Please click "create a new Query" if you are a new visitor to our website and need further information from us.
If you are already a member of our network and need to keep track of any developments regarding a question you have already submitted, click "take me to my Query."