Prevention of femoral nerve injuries in gynecologic surgery

Abdominopelvic operation is the most frequent cause of iatrogenic femoral nerve injury, particularly when self-retaining retractors are used. Transverse abdominal incisions and thin body habitus are significant risk factors. Patients typically have mild sensory and/or motor disturbances with diminished knee jerk reflexes. Most cases are self-limited, and symptoms resolve within several weeks. Most femoral nerve injuries that are associated with pelvic surgery can be prevented with a thorough understanding of the pelvic anatomy and proper placement of self-retaining retractors. (Am J Obstet Gynecol 2002;186:1-7.)