Lower limb compartment syndrome as a complication of laparoscopic laser surgery for severe endometriosis.

Objective: To report a case of lower limb compartment syndrome (LLCS) during long duration laparoscopic interventions for resection of extensive endometriosis, and evaluate the efficiency of a novel patient positioning method to reduce its prevalence.

Design: Case report and observational study.

Setting: University Hospitals, Belgium.

Patient(s): Thirty-year-old woman undergoing a long duration laparoscopic intervention for resection of stage IV pelvic endometriosis.

Intervention(s): Laparoscopic intervention for resection of stage IV pelvic endometriosis.

Main Outcome Measure(s): The occurrence of LLCS after laparoscopic surgery for extensive endometriosis, in this case, and the prevention of subsequent LLCS after the application of a novel patient positioning method including the following steps: maximal avoidance of the lithotomy position, patient positioning in a modified supine position, mobilization of the legs of the patient in between different surgical phases, and application of intermittent compression stockings.

Result(s): The prevalence of lower limb compartment syndrome has been reduced to 0 since the application of the new patient positioning method.

Conclusion(s): Lower limb compartment syndrome can be prevented in patients undergoing long duration multidisciplinary laparoscopic resection of extensive endometriosis by a novel sequential positioning method of patients before and during surgery.