Which case involves a 38-year-old plumber with arm pain after robotic surgery to repair a torn ligament?

• A. Edward Marks
• B. Arthur Bailey
• C. Margaret Paul
• D. Alex Brody

Answer: (A)

In this scenario, the key idea is that nerve injury can result from how a patient is positioned during robotic surgery, especially when the arms are held in an abducted and extended position for an extended period. Prolonged traction on the brachial plexus during robotic setup and instrument docking can stretch these nerves, leading to neuropraxia that presents as arm pain after the procedure.

So in the Edward Marks case, the 38-year-old plumber’s arm pain after robotic repair of a torn ligament fits this pattern. The pain is most consistent with a traction injury to the brachial plexus caused by intraoperative positioning rather than a direct injury to the joint or a complication unrelated to positioning. This reflects a known risk of robotic surgery when the upper limbs are secured in a fixed, exaggerated position for the duration of the operation.

Other potential postoperative issues would present with different symptom patterns—for example, symptoms localized to a specific peripheral nerve distribution or cranial nerve deficits—so they don’t align with a traction-related brachial plexus injury from surgical positioning.