SURGICAL POSITIONS USED IN

THEATRE

BWALYA MUNJILI
(Msc. Nsg, Bsc. Nsg, RoTN, RN)

MUNJILI 1
 INTRODUCTION
• Surgical positioning is the practice of
placing a patient in a particular physical
position during surgery
• The goal in selecting and adjusting a
particular surgical position is to maintain
the patient's safety while allowing access
to the surgical site
 ……………..
• Often a patient must be placed in an
unnatural position to gain access to
the surgical site
• Positioning normally occurs after the
administration of anesthesia
 FACTORS AFFECTING THE
SELECTION OF THE POSITION
• location of the surgical site
• Body alignment
• Circulation and respiratory constraints
• Musculatory system
• Physical traits of the patient such as the size,
age, weight, physical condition, and allergies
• The type of anesthesia used also affects the
decision
 COMON POSITIONS
A) Supine position
• The supine position is a position of the
body lying with the face up
• It is used in surgical procedures of the
peritoneal, thoracic and pericardial
regions; as well as the head, neck and
extremities
 PRONE POSITION
• Prone position, which is face down,
sometimes with the hands behind the head or
neck
• Using anatomical terms of location, the dorsal
side is down, and the ventral side is up
• Used in the surgical procedures of the spine
and the head
 Semi-supine
• Semi-supine commonly refers to
positions where the upper body
is tilted (at 45° or variations) and
not horizontal
 Trendelenburg position
• In the Trendelenburg position, the body is
laid flat on the back (supine position) with
the feet higher than the head by 15-30
degrees
• In the reverse Trendelenburg position, the
body is tilted in the opposite direction
• It was named after the German surgeon
Friedrich Trendelenburg
 ………..
• This is a standard position used in
abdominal and gynecological
surgery
• It allows better access to the
pelvic organs as gravity pulls the
intestines away from the pelvis.
 Lloyd-Davies position
• Lloyd-Davies position is a medical term
referring to a common position for
surgical procedures involving the pelvis
and lower abdomen
• The majority of colorectal and pelvic
surgery is conducted with the patient in
the Lloyd-Davis position
Lloyd-Davies position
 Lithotomy position
• The lithotomy position involves
the positioning of an individual's
feet above or at the same level as
the hips (often in stirrups), with
the perineum positioned at the
edge of an examination table
 …………
• It is for surgical procedures and
medical examinations involving
the pelvis and lower abdomen, as
well as a common position for
childbirth in Western nations
 …………..

• It is also used for prolonged

surgical procedures of the
pelvic cavity and perineum
Lithitom position
Fowler's position
 ………………
• Upright at 90⁰ is full or high
Fowler's position
• It is named by George Ryerson
Fowler
 Types/variations of fowler’s
position
• There are several types of Fowler's positions:
– Low Fowler's position is when the head of
bed is elevated 15-30 degrees
– Semi-Fowler's position is when the head of
bed is elevated 30-45 degrees
– Standard Fowler's is when the head of bed
is elevated 45-60 degrees
– High Fowler's position is when the head of
bed is elevated 80-90 degrees
 Uses
• In medicine, Fowler's position is a
standard patient position
• It is an intervention used to promote
oxygenation via maximum chest
expansion and is implemented
during events of respiratory distress
 …………
• It is used in postpartum women to
improve uterine drainage
• It is also used when oral or nasal gastric
feeding tubes as it minimizes the risk of
aspiration. Peristalsis and swallowing are
aided by the effect of gravitational pull.
 Sims' position
• The Sims' position, named after the
gynaecologist James Marion Sims
• It is usually used for rectal examination,
treatments and enemas
• It is performed by having a patient lie on their
left side, left hip and lower extremity straight,
and right hip and knee bent. It is also called
lateral recumbent position
 Others
Kidney position
• The kidney position is much like the lateral
position except the patient's abdomen is
placed over a lift in the operating table that
bends the body to allow access to the
retroperitoneal space
• A kidney rest is placed under the patient at
the location of the lift
 ………………..
Jackknife position
• Also called the Kraske position
• Patient's abdomen lies flat on the
bed
• The bed is scissored so the hip is
lifted and the legs and head are low
 …………..

Knee-chest position
• Similar to the jackknife except
the legs are bent at the knee
at a 90 degree angle.
 …………….
Lateral position
• Also called the side-lying position, it
is like the jackknife except the
patient is on his or her side
• Other similar positions are Lateral
chest and Lateral kidney.