Demonstrate proper patient positioning of laparoscopy
Leaner Task: You are now in the operating room. You plan to do a laparoscopy. The patient has been given general endotracheal anesthesia. Demonstrate proper patient positioning of laparoscopy.
Educator Checklist: Patient Positioning for Laparoscopy
Mark the appropriate column to indicate whether the learner included each element in his or her response. When completed, tally the “Included” column to calculate the learner’s score.
| KNOWLEDGE | |||
| General | Included =1 | Not included =0 | |
| Describes the most common positions for patients in routine gynecologic procedures. | |||
| Describes the goal of patient positioning for surgery | |||
| Describes the risks if surgical positioning is done incorrectly | |||
| Describes the appropriate steps in patient positioning in surgery | |||
| Lateral aspect of knee | Included =1 | Not included =0 | |
| Nerve at risk (common peroneal) | |||
| Consequence of injury (decreased sensation on lateral lower leg, dorsal foot, foot drop) | |||
| Correct position to avoid injury (knee toward opposite shoulder, no pressure on lateral aspect) | |||
| Elbow | Included =1 | Not included =0 | |
| Nerve at risk (ulnar) | |||
| Consequence of injury (decreased sensation and weakness in 4th and 5th digits) | |||
| Correct position to avoid injury (elbow padded, arm pronated, avoid hyperextension) | |||
| Hip | Included =1 | Not included =0 | |
| Nerve at risk (femoral and lateral femoral cutaneous) | |||
| Consequence of injury (sensory deficit of thigh, weakness of hip flexion, knee extension) | |||
| Correct position to avoid injury (no hyperflexion of hip, limit abduction and external rotation) | |||
| SKILLS | |||
| Body | Included =1 | Not included =0 | |
| Buttocks at edge of bed, no sacral pressure | |||
| Patient centered on bed | |||
| Accurately assesses cervical effacement | |||
| Arms | Included =1 | Not included =0 | |
| Arms tucked | |||
| Arms pronated, thumbs up or thumbs in | |||
| No hyperflexion or hyperextension of elbow | |||
| No hyperflexion or hyperextension of wrist | |||
| Arms padded | |||
| Fingers safe | |||
| Legs | Included =1 | Not included =0 | |
| Lithotomy stirrup clips at level of the greater trochanter or ASIS | |||
| Heels snug in the boot, weight of patient on the heel, heel at back of boot | |||
| Ankle, knee, hip, umbilicus, opposite shoulder all in alignment | |||
| No pressure on posterior calf | |||
| No pressure on lateral aspect of leg | |||
| No hyperflexion or hyperextension of hips | |||
| No hyperflexion or hyperextension of knees | |||
| Limit abduction and external rotation | |||