Lower limb compartment syndrome as a complication of robot-assisted radical prostatectomy: the UK experience


Correspondence: Conrad V. Bishop, Unit 3, 28 Carlingford Road, London NW3 1RX, UK.

e-mail: conradbishop@hotmail.com



  • To evaluate the incidence of lower limb compartment syndrome (LLCS) in robot-assisted radical prostatectomy (RARP) and the prevalence of risk factors in patients with LLCS.


  • Data were collected from 17 UK robotic surgery institutions for a multicentre analysis.
  • Data were used to calculate the incidence of LLCS and the prevalence of risk factors.


  • A total of 3110 RARPs were performed by 17 institutions between 2004 and 2011.
  • There were nine cases of LLCS, giving an incidence of 0.29%. Seven of these required fasciotomy.
  • The prevalence of risk factors was as follows: console time >4 h in 8/9 cases, early learning curve (<20 cases) in 3/9 cases; obesity (BMI >30 kg/m2) in 5/9 cases; and peripheral vascular disease in 2/9 cases. One patient with LLCS was positioned incorrectly.


  • The serious complication LLCS occurs in RARP but has a low incidence.
  • Long operating times, surgical inexperience, poor patient positioning, obesity and vascular disease appear to be risk factors.