The lithotomy position is a common position for surgical procedures and medical examinations involving the pelvis and lower abdomen, as well as a common position for

childbirth Childbirth, also known as labour, parturition and delivery, is the completion of pregnancy, where one or more Fetus, fetuses exits the Womb, internal environment of the mother via vaginal delivery or caesarean section and becomes a newborn to ...

in Western nations. 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 The perineum (: perineums or perinea) in placentalia, placental mammals is the space between the anus and the genitals. The human perineum is between the anus and scrotum in the male or between the anus and vulva in the female. The perineum is ...

positioned at the edge of an examination table. References to the position have been found in some of the oldest known medical documents including versions of the Hippocratic oath (see

lithotomy Lithotomy from Greek for "lithos" (stone) and "tomos" ( cut), is a surgical method for removal of calculi, stones formed inside certain organs, such as the urinary tract (kidney stones), bladder (bladder stones), and gallbladder (gallstones), t ...

); the position is named after the ancient surgical procedure for removing

kidney stones Kidney stone disease (known as nephrolithiasis, renal calculus disease, or urolithiasis) is a crystallopathy and occurs when there are too many minerals in the urine and not enough liquid or hydration. This imbalance causes tiny pieces of cr ...

and

bladder stones A bladder stone is a stone found in the urinary bladder. Signs and symptoms Bladder stones are small mineral deposits that can form in the bladder. In most cases bladder stones develop when the urine becomes very concentrated or when one is ...

via the perineum. The position is perhaps most recognizable as the 'often used' position for childbirth: the patient is laid on the back with knees bent, positioned above the hips, and spread apart through the use of

stirrup A stirrup is a light frame or ring that holds the foot of a rider, attached to the saddle by a strap, often called a ''stirrup leather''. Stirrups are usually paired and are used to aid in mounting and as a support while using a riding animal ...

s. The position is frequently used and has many obvious benefits from the doctor's perspective. Most notably the position provides good visual and physical access to the perineal region. The position is used for procedures ranging from simple pelvic exams to surgeries and procedures including those involving

reproductive organs A sex organ, also known as a reproductive organ, is a part of an organism that is involved in sexual reproduction. Sex organs constitute the primary sex characteristics of an organism. Sex organs are responsible for producing and transporting ...

urology Urology (from Ancient Greek, Greek wikt:οὖρον, οὖρον ''ouron'' "urine" and ''wiktionary:-logia, -logia'' "study of"), also known as genitourinary surgery, is the branch of medicine that focuses on surgical and medical diseases of t ...

, and

gastrointestinal The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The tract is the largest of the body's systems, after the cardiovascular system. ...

systems. New observations and scientific findings, combined with a greater sensitivity to patient needs have raised awareness of the physical and psychological risks the position may pose for prolonged surgical procedures, pelvic examinations, and, most notably, childbirth.

Use for prolonged surgical procedures

Some studies have found a significant relationship between prolonged surgical procedures with the patient in the lithotomy position and a circulatory complication known as

compartment syndrome Compartment syndrome is a serious medical condition in which increased pressure within a Fascial compartment, body compartment compromises blood flow and tissue function, potentially leading to permanent damage if not promptly treated. There are ...

. Nerve injury by pressure is also possible, the femoral or peroneal nerve are at risk.

Use for childbirth

Cochrane Review Cochrane is a British international charitable organisation formed to synthesize medical research findings to facilitate evidence-based choices about health interventions involving health professionals, patients and policy makers. It includes ...

found that the lithotomy position may not be the ideal position for

, noting that while it makes care easier for physicians by placing the patient in an easily accessible position, it is often harder on the patient as use of the lithotomy position can narrow the birth canal by up to a third. In lieu of the lithotomy position, the Cochrane Review recommended women make informed choices about birthing positions and find the position that is most comfortable for them.

Use for pelvic examinations

Patients have reported feeling a loss of control and increased sense of vulnerability when examined in the lithotomy position because they cannot see the area being examined. Other, equally effective positions have been suggested for examinations of conscious patients.

References

External links

Lithotomy Position
Information and research on the use of the Lithotomy Position in Childbirth
Effect Of Lithotomy Position On Spinal Anesthesia
{{DEFAULTSORT:Lithotomy Position Human positions Childbirth

Use for prolonged surgical procedures

Use for childbirth

Use for pelvic examinations

See also

References

External links