Isolated Left Peroneal Neuropathy Following Total Laparoscopic Hysterectomy: A Case Report

TL;DR

A woman developed left peroneal nerve damage after a laparoscopic hysterectomy, highlighting the need for proper surgical positioning to prevent such injuries.

Contribution

This case report documents a rare instance of isolated left peroneal neuropathy following a minimally invasive hysterectomy.

Findings

The patient exhibited steppage gait and foot dorsiflexion issues consistent with peroneal nerve injury.

Functional recovery occurred with rehabilitation, emphasizing early diagnosis and intervention.

The case underscores the importance of ergonomic measures during laparoscopic procedures.

Abstract

Neuropathy of the lower extremities is a rare surgical complication, usually caused by compression, stretching, or direct injury to the nerve during the procedure. Although such injuries have been documented in relation to laparotomies, there are few reports concerning minimally invasive procedures. Here, we present the case of a 46-year-old woman with a long-standing history of abnormal uterine bleeding. Imaging studies revealed large uterine myomatosis, indicating the need for a total laparoscopic hysterectomy. During the immediate postoperative period, the patient developed a steppage gait and an inability to dorsiflex her left foot, which is consistent with peroneal nerve neuropathy. The clinical course and additional tests confirmed the diagnosis, and the patient made a progressive functional recovery following rehabilitation. This case highlights the importance of proper surgical positioning and ergonomic measures during laparoscopic surgery to prevent compressive nerve injuries, as well as the importance of early identification to promote favorable clinical outcomes.

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