Lithotomy Position And Laparoscopic Procedures

In the last century, as far back as the twenties, there were examinations and surgeries done in the lithotomy position. This automatically became the favored position when it came to laparoscopic surgeries and procedures as well. The first laparoscopic procedure was done in the 20s and it was in the field of gynecology. In a hospital in New York, Dr. Albert Decker did the first culdoscopy using this position with great success.

The lithotomy position was used extensively in Europe through the last century and in Paris, surgeons popularized it especially in colposcopies. Because of this, it came to be known as the French position. With laparoscopy becoming very much a part of regular surgery, the lithotomy position too became popular. It had come far indeed from its lithotomy roots and its gynecological heritage.

In America, for laparoscopy surgical procedures, the supine position was more favored but with the European techniques crossing the ocean, there were more and more lithotomic positions being adopted by surgeons in the US. However, laparoscopic surgery in the lithotomy position seems to have its drawbacks. It results sometimes in too much pressure in the pelvic region and this brings about neurovascular damage. Sometimes this can lead to permanent disability. The problem is that many US clinics have adopted this position when it comes to any advanced surgery using laparoscopy. So there might need to be a winding back to the American position which is what the supine position was called when it came to laparoscopic procedures.

Studies and reports have been able to establish a link between the lithotomy position and post-operative compartment syndrome. This is what happens when there is excessive pressure in the osteofascial cavity because of the unnatural positioning of the patient. This pressure tends to interfere with the local perfusion and could result in a disability. This is a risk that no patient and maybe no clinic will want to take. This is why a reversal to go back to the supine position might not be a bad idea. It might not be as convenient for the physician to do his job but he can rest easy knowing that his patients did not suffer permanent damage just because he was interested more in his convenience than in their well being.