Posición operatoria en cirugía colorrectal. La importancia de lo básico

Better operative outcomes achieved with the prone jackknife vs. lithotomy position during abdominoperineal resection in patients with low rectal cancer

“…Perineal dissection is complicated in APR, and performing APR in the PJ position improved visualization, reduced the risks related to the operation, and made the operation easier to perform during this difficult part. Although the LT position provides adequate access to the rectovaginal septum and allows easy access to the posterior face of the rectum [ 10 ], this position is uncomfortable for the surgeons and assistants, blood tends to accumulate in the operation area, and adequate lighting is often challenging. Therefore, the surgeon has to spend more time for exposure, operative vision, and hemostasis and also to avoid iatrogenic damage to nerves, blood vessels, and organs.…”

“…Although the patient position needs to be changed during the operation in PJ-APR, this does not need a lot of time [ 14 ]. The PJ position is appropriate for almost all proctological surgeries, it allows an excellent exposure of the posterior and anal perineum and the anterior face of the rectum, provides a more comfortable position for the surgeon and assistants, results in less blood accumulation, and enables better lighting [ 10 ]. Our results showed that the time needed to change the operation position during PJ-APR was less than 18 min (data not shown); more time was saved in the process of perineal dissection.…”

“…Lithotomy (LT) and prone jackknife (PJ) positions are the two main positions currently used in APR. The LT position provides adequate access to the rectovaginal septum and allows easy access to the posterior face of the rectum [ 10 ]. However, this position is uncomfortable for the surgeons and the assistants, blood tends to accumulate in the operation area, and adequate lighting is often challenging.…”

Prospective evaluation of intraoperative peripheral nerve injury in colorectal surgery

“…In the upper limb, brachial plexus injury is the most common lesion observed. The basic strategy for the prevention of IPNI of the upper limbs is to limit abduction and cushion them at points of support [13,14]. However, Coppieters et al.…”

Transanal Endoscopic Video-Assisted Excision: Application of Single-Port Access

“…The laparoscopic instrumentation used for TEVA excision is not secured to the operating table as is required for TEM and the setup provides unimpeded deep and lateral instrument motion. Utilization of the lithotomy position may be associated with decreased risk for position-related nerve injuries 14–16 and loss of airway control 17,18 considered most often with the prone position.…”