One of the four main surgical patient positions, the lateral position is used for procedures that require surgical access to one side of the patient’s body. In the lateral position, the patient lies on one side. Some common procedures that may require a patient to be positioned in the lateral position include back surgeries, lower extremity surgeries, thoracic surgeries, Ear Nose Throat (ENT) surgeries, and kidney surgeries.1
The lateral position is used for surgical access to the thorax, kidney, retroperitoneal space, and hip.2 Depending on the side of the body on which the patient is being operated, the patient will lie on their left or right side. Before being placed in the lateral position, the patient is induced in the supine position. A team of Operating Room staff will then lift and turn the patient onto their nonoperative side. The patient is placed into the supine position toward the edge of the operative side of the surgical table and then turned onto the side toward the center of the table.
When positioning a patient in the lateral position, surgical staff should use safe practices and guidelines.1,3 The following are to be used as appropriate based on individual patient variables and the procedure. Surgical staff should refer to their facility's positioning policies and procedures for the safe positioning of patients.
As with all surgical positions, surgical staff should be aware of risks to the patient in the lateral position.
Complications associated with lateral position include:1,3
Depending on the side of the body on which the patient is being operated, the patient will lie on their left or right side. In the left lateral position, the patient lies on the left side of their body for a surgical procedure on their right side. For surgery on the left side of their body, the patient lies on the right side.
Variations of the lateral position include lateral kidney position, lateral chest position, lateral sims recumbent position, and lateral jackknife position. The lateral kidney position is commonly used for kidney surgeries. Lateral chest position is used for unilateral transthoracic procedures.
Anesthesia Armboards – Lightweight and carbon fiber, these Anesthesia Armboards are designed to allow access for anesthesia caregivers during a procedure while a patient is in the prone position. The Anesthesia Armboard easily attaches to any standard siderail with its integral attachment clamp and is enhanced for durability with protective edging to safeguard against damage.
Multi-Posture Armboard – The padded arm support constructed of lightweight carbon fiber provides versatile positioning for lateral, supine, prone, and seated patient postures. This armboard provides appropriate alignment of arms in the lateral position.
ELITE™ Lateral Positioner – This positioner permits a safe, quick, and easy transition from the supine position to the lateral position. The patient’s lower shoulder fits into the integral channel to provide exceptional patient comfort and nerve protection while in the lateral position. The built-in headrest and axillary support assists in proper spinal alignment and surgical site access.
ELITE™ Supine Headrest – This headrest can be used to support the patient’s head in both supine and lateral positions. The 3-dimensional cradling of the patient’s head provides volumetric redistribution of pressure to protect against the onset of pressure sores.
Foot Extension – The foot extension supports the patient’s feet when applied to general surgical tables in a perpendicular fashion. Footboards assist in preventing nerve damage and unintended patient movement in reverse Trendelenburg position.
Patient Restraint Strap – Patient Restraint Strap is a reinforced synthetic elastomer belt and strap with quick-release clamps for easy yet secure, adjustable positioning on the surgical table's siderails. The strap is compatible for use with all surgical tales and table extensions with siderails.
One of the four main patient positions, the lateral position provides access to the operative side of the patient’s body. Surgical staff should consider risks and complications associated with the lateral position such as pressure to structures of the dependent side of the body including the ears, shoulders, and ribs, brachial plexus injury, venous pooling, and diminished lung capacity.
Variations to the lateral position include the lateral kidney position, lateral chest position, and lateral jackknife position.
Regardless of what position is being used for a patient during a procedure, it’s important to follow best practices for positioning.1
Lena Elias-Fogle, BSN RN, CNOR
Director, Global Clinical Solutions
Lena is a seasoned healthcare leader with extensive experience leading complex perioperative environments as well as new program development, continuous process improvement, clinical outcomes, operational excellence, and stakeholder experience.
1 Guideline for positioning the patient. (2017). AORN Journal, 105(4), P8-P10. doi:10.1016/s0001-2092(17)30237-5
2 Positioning the Patient for Surgery. Jones & Bartlett Learning, LLC, an Ascend Learning Company.
3 Rothrock, J. C. (2011). Alexander's care of the patient in surgery (14th ed.). St. Louis, MO: Mosby.