24 OP23 Intraoperative peripheral nerve injury related to lithotomy positioning with steep Trendelenburg in patients undergoing robotic-assisted laparoscopic surgery: a systematic review B. Bjøro1, I. Mykkeltveit2, T. Rustøen3, B.C. Altinbas4, O. Røise5, S.B. Bentsen6 1Oslo University Hospital, Department of Operating Services, Division of Emergencies and Critical Care, Oslo, Norway, 2University of Stavanger, Faculty of Health Science, Stavanger, Norway, 3Oslo University Hospital, University of Oslo, Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, Oslo, Norway, 4Karadeniz Technical University, Department of Surgical Disease Nursing, Faculty of Health Science, Karadeniz, Turkey, 5Oslo University Hospital, University of Oslo, Division of Orthopedics Surgery, Institute of Clinical Medicine, Oslo, Norway, 6Western Norway University of Applied Sciences, Oslo University Hospital, Department of Health and Caring Sciences, Department of Operating Services, Bergen, Norway Background and aim: In spite of the fact that robotic-assisted laparoscopic surgery is less stressful for the patients, there are some challenges associated with positioning of the patients on the operating table. The aim of this systematic review was to examine the incidence of intraoperative peripheral nerve injury, symptoms, risk factors and function in patients undergoing robotic-assisted laparoscopic surgery related to lithotomy positioning with steep Trendelenburg. Methods: A systematic review using guidance for the Cochrane Handbook for systematic review and PRISMA was performed from January 2000–February 2019. Titles and abstracts were screened for inclusion criteria. Full-text assessments of each paper were conducted by two reviewers. The quality of the included papers was assessed using the Mixed Methods Appraisal Tool. Descriptive statistics and thematic analysis were used to synthesize the data. Results: Eleven quantitative studies were included with three themes: incidence of intraoperative peripheral nerve injury; upper extremity intraoperative peripheral nerve injury related to steep Trendelenburg positioning; and lower extremity intraoperative peripheral nerve injury related to lithotomy positioning. The overall incidence of intraoperative peripheral nerve injury in robotic-assisted urologic, gynecologic, and colorectal surgery was 0.16–10.0%, and the symptoms appeared immediately after surgical procedures. Risk factors for intraoperative peripheral nerve injury were prolonged operative time, high ASA scores, comorbidities, and high BMI. Conclusion: Intraoperative peripheral nerve injuries are rare, but occasionally serious complications following lithotomy positioning with steep Trendelenburg. Operating room nurses have a responsibility both for positioning patients and for being familiar with the technological developments that will influence the preoperative handling of patients. Increased robotic-assisted laparoscopic surgery necessitates further research examining the incidence of intraoperative peripheral nerve injury. 10th EORNA Congress Stavanger, Norway | 12 - 15 May 2022 Parallel Sessions
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