Lithotomy position Supine position on the operating table End of the table removed Patient is moved to the lower

edge of the operating table with the legs held by an assistant The anterior superior iliac spine should be positioned at the level of the break in the table The legs are held before being placed in the stirrups Legs are usually placed outside of the poles to avoid pressure on the common peroneal nerve. Considerations o Avoid hyperflexion of the hips o Ensure adequate padding between the legs and poles o Avoid overhanging buttocks at the end of the operating table o After procedure the feet are returned to the anatomical position in a controlled manner. Pedal pulses are checked and the calves are massaged. Surgical approaches o rectum, e.g, abdominal-perineal excision of the rectum o endoscopic urological procedures o genitourinary procedure o perianal procedures

Lloyd-davies position similar position as for lithotomy padding esp required around the calves to protect the common peroneal nerve in the lower leg the hands can enter the operative field and can also touch the poles. These should be protected by padding and tucked on gently into the body and covered surgical approaches o rectum esp anterior resection o genitourinary surgery o pelvic surgery where access is required from both abdominal and perineal aspects o variations: laparoscopic upper gastrointestinal surgery, e.g., anti-reflux surgery