S
urgery has changed dramatically in the last 10 or 15
years, and so should many of the practices related to
the Trendelenburg position — especially steep
Trendelenburg. Laparoscopic and robotic cases, practi-
cally unheard of when many of us were residents, are
now standard. We're tackling increasingly complex and longer proce-
dures on heavier patients. Taken together, those factors should
strongly influence whether, and to what degree, we decide to tilt our
patients backwards to gain better access.
I visit a lot of hospitals and surgery centers and watch a lot of sur-
geons operate. So I see firsthand that a lot of folks are still operating
as though it's 1996, instead of adapting to the often-challenging reali-
ties of 2016. Here are 12 suggestions to consider before you lower the
head and raise the feet of another patient.
7 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A R C H 2 0 1 6
12 Tips for Safe
Trendelenburg Positioning
Read this surgeon's advice before you lower the head and raise
the feet of another patient. Ali Ghomi, MD, FACOG | Buffalo, N.Y.
• STEEP THOUGHTS Some anatomy is
independent of gravity, so a 40-degree tilt
may be no more beneficial than 20 degrees.
Pamela
Bevelhymer,
RN,
BSN
