• Carla Tomassetti, Christel Meuleman, Bernard Vanacker, and Thomas D'Hooghe.
• Department of Obstetrics and Gynaecology, Leuven University Fertility Centre, University Hospitals Leuven, Leuven, Belgium.
• Fertil. Steril. 2009 Dec 1; 92 (6): 2038.e9-12.

ObjectiveTo report a case of lower limb compartment syndrome (LLCS) during long duration laparoscopic interventions for resection of extensive endometriosis, and evaluate the efficiency of a novel patient positioning method to reduce its prevalence.DesignCase report and observational study.SettingUniversity Hospitals, Belgium.Patient(S)Thirty-year-old woman undergoing a long duration laparoscopic intervention for resection of stage IV pelvic endometriosis.Intervention(S)Laparoscopic intervention for resection of stage IV pelvic endometriosis.Main Outcome Measure(S)The occurrence of LLCS after laparoscopic surgery for extensive endometriosis, in this case, and the prevention of subsequent LLCS after the application of a novel patient positioning method including the following steps: maximal avoidance of the lithotomy position, patient positioning in a modified supine position, mobilization of the legs of the patient in between different surgical phases, and application of intermittent compression stockings.Result(S)The prevalence of lower limb compartment syndrome has been reduced to 0 since the application of the new patient positioning method.Conclusion(S)Lower limb compartment syndrome can be prevented in patients undergoing long duration multidisciplinary laparoscopic resection of extensive endometriosis by a novel sequential positioning method of patients before and during surgery.

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