Abstract
To compare patient slide in Trendelenburg position using egg-crate foam or gel pad. This randomized trial compared slide on friction pads during Trendelenburg position for robotic and laparoscopic gynecologic procedures in 61 patients at the Mayo Clinic Florida between March 11, 2010 and May 31, 2011. Data was analyzed using Student’s t test with significance defined as p ≤ 0.05. There was no significant difference in mean slide according to pad type (foam 3.0 ± SD 2.1 cm; gel 4.5 ± SD 4.0 cm, p = 0.08). Minor complaints occurred in 10 % of patients, and did not differ by group (p = 0.4). Most complaints (98 %) were transient shoulder or neck pain. A single patient had both transient right hand numbness and right lateral thigh paresthesia. We assessed outcomes by chart review from the inpatient care and postoperative evaluation notes (mean 44 ± SD 17 days), and by review of any intervening notes that occurred before the study’s end (mean 345 ± SD 116 days). Trendelenburg-related slide is equivalent on either egg-crate foam or gel pad.
Similar content being viewed by others
References
Coppieters MW (2006) Shoulder restraints as a potential cause for stretch neuropathies: biomechanical support for the impact of shoulder girdle depression and arm abduction on nerve strain. Anesthesiology 104(6):1351–1352
Coppieters MW, Van de Velde M, Stappaerts KH (2002) Positioning in anesthesiology: toward a better understanding of stretch-induced perioperative neuropathies. Anesthesiology 97(1):75–81
Romanowski L, Reich H, McGlynn F, Adelson MD, Taylor PJ (1993) Brachial plexus neuropathies after advanced laparoscopic surgery. Fertil Steril 60(4):729–732
Shveiky D, Aseff JN, Iglesia CB (2010) Brachial plexus injury after laparoscopic and robotic surgery. J Minim Invasive Gynecol 17(4):414–420
Warner M, Blitt C, Butterworth J, Clark R, Connis R, Curling S, Martin J, Nickinovich D, Saidman L, Stoelting R (2000) Practice advisory for the prevention of perioperative peripheral neuropathies: a report by the American Society of Anesthesiologists Task Force on Prevention of Perioperative Peripheral Neuropathies. Anesthesiology 92(4):1168–1182
Barnett JC, Hurd WW, Rogers RM Jr, Williams NL, Shapiro SA (2007) Laparoscopic positioning and nerve injuries. J Minim Invasive Gynecol 14(5):664–672 (quiz 73)
Hewer CL (1953) Maintenance of the Trendelenburg position by skin friction. Lancet 1(6759):522–524
Klauschie J, Wechter M, Jacob K, Zanagnolo V, Montero R, Magrina J et al (2010) Use of anti-skid material and patient-positioning to prevent patient shifting during robotic-assisted gynecologic procedures. J Minim Invasive Gynecol 17(4):504–507
Moher DHS, Schulz KF, Montori V, Gotzsche P, Devereaux PJ, Elbourne D, Egger M, Altman DG (2010) Consort 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. BMJ 340(c869):1–28
Schulz KF, Altman DG, Moher D (2010) CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Ann Intern Med 152(11):726–732
Conflict of interest
None of the authors has a conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Additional information
CLINICAL TRIAL REGISTRATION, ClinicalTrials.gov: 09-000685-01, www.clinicaltrials.gov.
Condensation
In this randomized study, patient slide during Trendelenburg position was similar on either egg-crate foam or a gel pad.
Rights and permissions
About this article
Cite this article
Wechter, M.E., Kho, R.M., Chen, A.H. et al. Preventing slide in Trendelenburg position: randomized trial comparing foam and gel pads. J Robotic Surg 7, 267–271 (2013). https://doi.org/10.1007/s11701-012-0370-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11701-012-0370-3