Editing Lithotomy position

{{Short description|Position for medical examinations and procedures}}
[[File:Lithotomy position.jpg|thumb|Lithotomy position.]]
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]] 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]] 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]]); the position is named after the ancient surgical procedure for removing [[kidney stones]] and [[bladder stones]] 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]]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|reproductive organs]], [[urological|urology]], and [[gastrointestinal]] 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]].<ref name="pmid10893585">{{cite journal|author5-link=Hunter Wessells|vauthors=Anema JG, Morey AF, McAninch JW, Mario LA, Wessells H |title=Complications related to the high lithotomy position during urethral reconstruction |journal=Journal of Urology |volume=164 |issue=2 |pages=360–3 |date=August 2000 |pmid=10893585 |doi= 10.1016/S0022-5347(05)67360-0}}</ref><ref name="pmid11336771">{{cite journal |vauthors=Cohen SA, Hurt WG |title=Compartment syndrome associated with lithotomy position and intermittent compression stockings |journal=[[Obstet Gynecol]] |volume=97 |issue=5 Pt 2 |pages=832–3 |date=May 2001 |doi= 10.1016/S0029-7844(00)01141-8|pmid=11336771|s2cid=2257854 }}</ref> Nerve injury by pressure is also possible, the femoral or peroneal nerve are at risk.<ref>Manski, D: Online textbook of urology http://www.urology-textbook.com/lithotomy-position.html</ref>

==Use for childbirth==
A [[Cochrane Review]] found that the lithotomy position may not be the ideal position for [[childbirth]], 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.<ref>{{Cite journal |doi = 10.1002/14651858.CD002006.pub4|title = Position in the second stage of labour for women without epidural anaesthesia|journal = Cochrane Database of Systematic Reviews|year = 2017|last1 = Gupta|first1 = Janesh K.|last2 = Sood|first2 = Akanksha|last3 = Hofmeyr|first3 = G Justus|last4 = Vogel|first4 = Joshua P.| volume=2017 | issue=5 | pages=CD002006 | pmid=28539008 |pmc = 6484432}}</ref>

==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.<ref name="urlEditorials&nbsp;— July 1, 2000 - American Family Physician">{{cite web |url=http://www.aafp.org/afp/20000701/editorials.html |title=Editorials&nbsp;— July 1, 2000 - American Family Physician |website= |accessdate=}}</ref><ref name="pmid16803941">{{cite journal  |vauthors=Seehusen DA, Johnson DR, Earwood JS, etal |title=Improving women's experience during speculum examinations at routine gynaecological visits: randomised clinical trial |journal=[[BMJ]] |volume=333 |issue=7560 |pages=171 |date=July 2006 |pmid=16803941 |doi=10.1136/bmj.38888.588519.55 |pmc=1513491}}</ref>{{such as?|s|date=November 2022}}

==See also==
*[[Childbirth positions]]

==References==
{{reflist}}

==External links==
* [https://web.archive.org/web/20101025223022/http://birthingnaturally.net/barp/lithotomy.html Lithotomy Position]. Information and research on the use of the Lithotomy Position in Childbirth
* [http://www.lithotomyposition.net/effect-of-lithotomy-position-on-spinal-anesthesia.php Effect Of Lithotomy Position On Spinal Anesthesia]

{{DEFAULTSORT:Lithotomy Position}}
[[Category:Human positions]]
[[Category:Childbirth]]