What is the lithotomy position?

Many people are not particularly familiar with the lithotomy position. This is a position required for anorectal surgery. In this position, the patient should lie on his back on the bed with his buttocks close to the edge of the bed, and then put his legs on a leg rest. This will expose the perineum and anus to the greatest extent. This is a common position for rectal surgery, anal canal surgery and gynecological examinations.

Scope of application : 1. Examination, treatment or surgery of the anus and perineum, such as cystoscopy, obstetrics and gynecology examination, etc. 2. During childbirth.

Recommendation: The surgical position is a forced posture that the patient adopts to adapt to medical needs. The lithotomy position is suitable for perineal surgery, radical resection of rectal cancer, etc. This type of surgery is difficult and takes a long time. In addition, under anesthesia, the lower limbs lose sensation, which can easily lead to excessive muscle stretching, artery and nerve compression, electric shock and other adverse reactions.

Precautions

1. Explain precautions to the patient to prevent him from falling out of bed. 2. Keep warm and cover yourself appropriately. 3. Protect patient privacy by using a screen. 4. The hand on the hand support board should not be abducted more than 90 degrees to avoid damaging the brachial plexus. 5. Do not place the popliteal fossa too close to the leg frame to avoid damaging the popliteal fossa blood vessels, nerves and gastrocnemius muscle. 6. Raise your feet slightly to avoid venous thrombosis. 7. Secure the limbs properly and do not leave them hanging in the air.

Lithotomy position steps

1. The lithotomy position is often used in vaginal hysterectomy, rectal surgery, cystoscopic surgery and other surgeries. The specific placement method is: the patient lies on his back and wears leg sleeves. Then move the patient down so that the sacrum and coccyx slightly extend beyond the lower edge of the backboard, and place both legs on the leg rest. 2. Common adverse reactions include local skin compression, common peroneal nerve injury and venous thrombosis. 3. Causes of adverse reactions

4. Local skin compression: The patient already has blood circulation disorder in the lower limbs before the operation; no proper padding is added to the bony protrusions; uneven padding and pressure from the surgeon can all lead to local skin compression. 5. Venous thrombosis The popliteal artery and popliteal vein, the main blood vessels that maintain blood circulation in the calf, are located in the popliteal fossa and lack the protection of muscle and fat tissue. Therefore, long-term pressure on the popliteal fossa can cause blood circulation disorders in the calf, causing damage to the vascular endothelium or the formation of venous thrombosis. Factors that cause excessive pressure on the popliteal fossa include: the restraint belt is too tight or improperly positioned; the knee joint flexion angle is too small. 6. Common peroneal nerve injury The common peroneal nerve is a branch of the sciatic nerve. It bypasses the fibular neck and passes through the peroneus longus muscle to the front of the calf. The common peroneal nerve is close to the skin where it bypasses the fibular neck and lacks the protection of muscle and fat tissue. If this area is compressed for a long time, it will cause damage to the common peroneal nerve.