Iatrogenic femoral neuropathy following pelvic surgery: a rare and often overlooked complication--four case reports and literature review.

Femoral neuropathy can result from diverse etiologies following abdominal surgery. We describe four cases of postoperative femoral neuropathy after proctological procedures that were carried out at our hospital. The related symptoms developed occultly but eventually impaired patient motor or sensory functions in the lower extremities. When the patient fails to address associated suffering, it is easy for clinicians to neglect this type of morbidity. All patients recovered from neuropathy following timely detection of the disease entity confirmed by electromyography and nerve conduction studies, followed by adequate rehabilitation management. We hypothesize that postoperative femoral neuropathy may be closely related to unsuitable applications of self-retaining retractors, rather than being associated with other factors, such as gender, age, surgery time or body mass index (BMI). Furthermore, we used a literature review to examine the pathophysiology, diagnoses and treatment modalities of femoral neuropathy resulting from inappropriate placement of selfretaining retractors. Based on a thorough comprehension of the femoral nerves anatomical course and meticulous placement of retractor blades, these types of iatrogenic complications may be prevented. (Chang Gung Med J 2007;30:374-9)