The Ultimate Guide to Lithotomy Position

Achieving a proper patient position while maintaining patient comfort and safety is key. When the patient is in the appropriate position, access to the surgical site is improved and the ability to perform the procedure is enhanced. To decrease the risk associated with patient positioning, it is important to understand the position, patient risk factors, and environmental risk factors. Lithotomy Position is one of the common positions used during many surgeries and in childbirth.

In this article you will learn:

• What is Lithotomy Position and the procedures its used for
• Lithotomy Position during childbirth and surgeries
• How do you place a patient in a Lithotomy Position
• Complications
• Common variations
• Alternative positions to Lithotomy Position during childbirth
• Lithotomy Positioning Devices

What is the Lithotomy Position?

The Lithotomy Position is similar to the supine position of the body when the patient is face-up, arms to the sides, but the legs are separated, raised, and supported in a boot-style leg holder or stirrup-style position. The most common procedures performed in the Lithotomy position are:

• Gynecological
• Urologic
• Colorectal
• Perineal, or Pelvis Procedures

Lithotomy position during childbirth

The Lithotomy Position can be used during childbirth since it provides the doctor with good access to the mother and the baby. It was used as the standard position for childbirth procedures, but recently, most hospitals have shifted to using birthing beds or chairs.

Studies have shown that Lithotomy Position can cause more pain for the woman in the second or third stage of labor vs other alternative positions like squatting positions.¹

Lithotomy position during surgery

Types of surgery that utilize the Lithotomy Position

Lithotomy Position is used during many operations including, but limited to:

• Urethral Surgery
• Colon Surgery
• Removal of the bladder, and rectal or prostate tumors
• Vaginal, cervical, and uterine surgical procedures

How do you place a patient in a Lithotomy Position?

The patient is placed on their back face-up and the head is supported by a patient positioning pad. The legs are elevated at their hips and the knees are bent at a 70 to a 90-degree angle. The legs are supported in padded footrests like leg stirrups. See Lithotomy Position image (2)

Complications associated with the Lithotomy Position

Like other patient positions, the Lithotomy Position can be associated with a patient increased risk for some strains or injuries, whether used during childbirth or surgery.

Complications during childbirth

• Increased chance of needing an episiotomy which is cutting the tissue between the vagina and anus, also called the perineum²
• Increased chance of needing a Caesarian section or forceps
• Increased chance of getting a sphincter injury due to increased pressure³

Complications during surgery

• Acute Compartment Syndrome when pressure increases within a specific area of your body⁴
• Nerve Injury⁵: includes two common injuries:
• Peripheral (peroneal) nerve injury increases with the length of surgery. Symptoms include ankle extension, ankle eversion, and foot dorsiflexion.
• Lateral femoral nerve injury which leads to lateral thigh pain or meralgia paresthetica.
• Other common injuries include hip dislocation, tendon and/or muscle strain, low back strain, Sciatic nerve injury, and pressure injuries. Learn about pressure injuries in our Pressure Ulcer Staging and Prevention Guide

Learn about Dabir Technology for pressure injury (ulcer) prevention

Common variations of the Lithotomy Position

The Lithotomy Position can take different variations depending on the type of surgical operation being held.

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