In the end, the patient should be positioned to give the surgeon suitable, free access to the operating site by removing the shoulder plate segment. If necessary, the arm can be positioned with abduction if required for the anaesthetic. On the operating side, the arm is usually positioned directly at the body (O Fig. 8.33).
The patient is placed under anaesthetic while still supine and rolled into the operating theatre still supine. In the operating theatre, the arm positioning devices are brought into position and the patient is turned over onto the abdo-
In this position, the upper body does not lie with its full weight on the back plate of the operating table but also puts pressure on the pelvis and thighs. Special attention
Fig. 8.35. Thorax support
Fig. 8.33. Shoulder positioning with segment removed
Fig. 8.35. Thorax support men by at least four persons. The positioning aids are fitted in position.
Before placing the head on the positioning aid, padding must be placed under the thorax!
But the procedure for changing the patient's position can be much simpler for everyone involved by preparing a second operating table with the corresponding positioning aids, adjusting it in height to be lower than the first operating table, and the patient is then rolled over into the prone position (O Figs. 8.36, 8.37).
In any case it is important to consult the anaesthetist to ensure that IV drips and monitoring leads (ECG) are secured or, preferably, disconnected while repositioning the patient.
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