Modified Lithotomy - Gynecology

What is the Modified Lithotomy Position?

The modified lithotomy position is a common patient positioning technique used in gynecological procedures and surgeries. It involves the patient lying on their back with their legs flexed at the hips and knees, and their feet supported by stirrups. This position provides optimal access to the pelvic organs for the healthcare provider.

Why is the Modified Lithotomy Position Used?

This position is primarily used to facilitate various gynecological examinations, surgeries, and procedures such as pap smears, hysteroscopy, and laparoscopic surgeries. It allows for better visualization and access to the vagina, cervix, and uterus, making it easier for the healthcare provider to perform necessary interventions.

How is the Modified Lithotomy Position Achieved?

To achieve the modified lithotomy position, the patient's hips are placed at the edge of the examination table. Their legs are then elevated and placed in stirrups. The angles of the hips and knees can be adjusted to provide the best access while ensuring patient comfort. Proper padding and support are essential to prevent pressure injuries.

What are the Benefits of the Modified Lithotomy Position?

The benefits include enhanced visibility and access to the pelvic organs, which is crucial for accurate diagnosis and effective treatment. It also allows for better control of surgical instruments and reduces the risk of complications during minimally invasive procedures.

What are the Risks Associated with the Modified Lithotomy Position?

While the modified lithotomy position is generally safe, it does come with some risks. Prolonged time in this position may lead to nerve damage, pressure sores, and circulatory issues. Proper positioning and regular monitoring are essential to mitigate these risks.

How Can Patient Comfort be Ensured?

Ensuring patient comfort involves using appropriate padding, adjusting the stirrups to the correct height, and providing adequate support for the legs and lower back. Communication with the patient throughout the procedure is crucial to address any discomfort promptly.

What are the Alternatives to the Modified Lithotomy Position?

Alternatives to the modified lithotomy position include the lateral decubitus position and the Trendelenburg position. These alternatives may be used based on the specific requirements of the procedure and the patient's condition.

Conclusion

The modified lithotomy position is a cornerstone technique in gynecological practice, providing essential access for various procedures and surgeries. While it offers numerous benefits, healthcare providers must be vigilant about potential risks and patient comfort to ensure safe and effective outcomes.

Relevant Publications

The relationship between stone-free and patient position in retrograde intrarenal surgery: a randomized prospective study.

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Standardization of robot-assisted radical nephroureterectomy via intraperitoneal approach: insights from a high-volume Japanese Center.

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Using Remotely Operated Suction Irrigation System in da Vinci SP Submucosal Dissection.

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Modified dorsal recumbent position versus lithotomy position for flexible ureteroscopic lithotomy: a multicenter prospective randomized controlled clinical trial.

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Lessons to Learn From 36 Cases of Well-Leg Compartment Syndrome in Colorectal Surgery: A Systematic Literature Review.

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Effect of different targets of goal-directed fluid therapy on intraoperative hypotension and fluid infusion in robot-assisted laparoscopic gynecological surgery: a randomized non-inferiority trial.

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Standard v mini percutaneous nephrolithotomy in the supine modified lithotomy position: a randomized pilot study on 10-25 mm stones.

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Transvaginal double-layer parallel in-situ suturing for early complex vesicovaginal fistula repair: Case report.

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Comparison of the carotid corrected flow time and tidal volume challenge for assessing fluid responsiveness in robot-assisted laparoscopic surgery.

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A Case Report of Multiple Renal Calculi Treated With Individualized Homoeopathy.

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A Case of Posterior Interosseous Nerve Palsy Associated With Robotic Low Anterior Resection.

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Robotic repair of perineal hernias: a video vignette and review of the literature.

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A Modified Semi-Lithotomy Position for Approach to Tibial Plateau Complex Fractures: A Technical Note.

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Robotic transanal excision of rectal lesions: expert perspective and literature review.

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Single-Port, Robot-Assisted Transanal Harvest of Rectal Mucosa Grafts for Substitution Urethroplasty.

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Single Port Endorobotic Rectal Mucosa Harvest For Urethral Reconstruction.

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Robot-assisted modified bilateral dismembered V-shaped flap pyeloplasty for ureteropelvic junction obstruction in horseshoe kidney using KangDuo-Surgical-Robot-01 system.

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Comparative analysis of retrograde intrarenal surgery and modified ultra-mini percutaneous nephrolithotomy in management of lower pole renal stones (1.5-3.5 cm).

Issue Release: 2020

How I Do It: Modification of technique to safely position patients with super obesity in dorsal lithotomy for ureteroscopic management of kidney stones.

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