Common positions for patients undergoing GI procedures include supine position,

low modified lithotomy position, and jackknife position. In supine or modified

lithotomy position, the patient's arms are secured on arm boards or tucked at the
sides. When there are surgical reasons to tuck the arms at the side, pad the elbows
to protect the ulnar nerve, turn the palms inward, and maintain the wrist in a neutral
position. When the patient is in modified lithotomy position with arms secured on
arm boards, ensure there is adequate space between the base of the arm boards
and the stirrup holders for the surgeon and first assistant to stand. This can be
challenging with patients of short stature. Ensure the hands and fingers are
protected when raising or lowering the foot of the operating room (OR) bed.
Exposure of key anatomy may require frequent intraoperative changes in the
orientation of the OR bed. Common positions used to shift abdominal organs away
from the operative site to optimize visualization include Trendelenburg, reverse
Trendelenburg, and tilting of the OR bed from side to side into a lateral position. The
surgical team collaboratively positions the patient and ensures that the patient is
secured properly to the OR bed before draping.