Nerve Injury

Nerve compression is a potential complication during the head-down position. Overextension of the arm must be avoided. Shoulder braces should be used with great caution and must not impinge on the brachial plexus. Lower extremity neuropathies (e.g., peroneal neuropathy, meralgia paresthetica, femoral neuropathy) have been reported after laparoscopy.^{[159] [160]} The common peroneal nerve is particularly vulnerable and must be protected when the patient is placed in the lithotomy position. Prolonged lithotomy position, such as required for some operative laparoscopies, can result in lower extremity compartment syndrome.