1. The document describes various surgical positions used during operations including supine, Trendelenburg, reverse Trendelenburg, fracture table, lithotomy, Fowler's, semi-Fowler's, prone, jackknife, knee-chest, lateral, kidney, and Sims' positions. 2. The most common positions are supine, prone, modified Trendelenburg, and lateral. Supine is used for many procedures while prone is used for back or spine surgery. 3. Proper positioning is important to provide surgical access while maintaining patient safety. Nurses must prepare equipment for each position and avoid potential hazards like skin breakdown or nerve damage.

1. Positions
Supine position
The most common surgical position. The patient lies with back flat on operating room bed. [1][2][3]
Trendelenburg position
Same as supine position but the upper torso is lowered. [1][2]
Reverse Trendelenburg position
Same as supine but upper torso is raised and legs are lowered. [1][2]
Fracture Table Position
For hip fracture surgery. Upper torso is in supine position with unaffected leg raised. Affected leg is extended with no lower support. The leg is strapped at the ankle and the re is padding in the groin to keep pressure on the leg and hip. [1]
Lithotomy position
Used for gynecological, anal, and urological procedures. Upper torso is placed in the supine position, legs are raised and secured, arms are extended.
Fowler's position
Begins with patient in supine position. Upper torso is slowly raised to a 90 degree position.
Semi-Fowlers position
Lower torso is in supine position and the upper torso is bent at a nearly 85 degree position. The patient's head is secured by a restraint.
Prone position
Patient lies with stomach on the bed. Abdomen can be raised off the bed.
Jackknife position
Also called the Kraske position.[2] Patient's abdomen lies flat on the bed. The bed is scissored so the hip is lifted and the legs and head are low. [1][2]
Knee-chest position
Similar to the jackknife except the legs are bent at the knee at a 90 degree angle.
Lateral position
Also called the side-lying position, it is like the jackknife except the patient is on his or her side. Other similar positions are Lateral chest and Lateral kidney.
Kidney position
The kidney position is much like the lateral position except the patient's abdomen is placed over a lift in the operating table that bends the body to allow access to the retroperitoneal space. A kidney rest is placed under the patient at the location of the lift.[2]
Sims' position
The Sims' position is a variation of the left lateral position. The patient is usually awake and helps with the positioning. The patient will roll to his or her left side. Ke eping the left leg straight, the patient will slide the left hip back and bend the right leg. This position allows access to the anus.
Surgical positions
From Wikipedia, the free encyclopedia
Surgical positioning is the practice of placing a patient in a particular physical position during surgery. The
goal in selecting and adjusting a particular surgical position is to maintain the patient's safety while allowing
access to the surgical site. Often a patient must be placed in an unnatural position to gain access to the
surgical site.[1]
Positioning normally occurs after the administration of anesthesia.[1][2]
In addition to considerations related to the location of the surgical site, the selection of a surgical position is
made after considering relevant physical and physiological factors, such as body alignment, circulation,
respiratory constraints, and the musculatory system to prevent stress on the patient. [1][2] Physical traits of the
patient must also be considered including size, age, weight, physical condition, and allergies. [2] The type of
anesthesia used also affects the decision.[2]
After The
The Back
Gastric bypass surgery
Knee replacement surgery
Surgical Positions
Operating Room Operating Room Procedure OR nurse

2. Positions
Supine position
The most common surgical position. The patient lies with back flat on operating room bed. [1][2][3]
Trendelenburg position
Same as supine position but the upper torso is lowered. [1][2]
Reverse Trendelenburg position
Same as supine but upper torso is raised and legs are lowered. [1][2]
Fracture Table Position
For hip fracture surgery. Upper torso is in supine position with unaffected leg raised. Affected leg is extended with no lower support. The leg is strapped at the ankle and the re is padding in the groin to keep pressure on the leg and hip. [1]
Lithotomy position
Used for gynecological, anal, and urological procedures. Upper torso is placed in the supine position, legs are raised and secured, arms are extended.
Fowler's position
Begins with patient in supine position. Upper torso is slowly raised to a 90 degree position.
Semi-Fowlers position
Lower torso is in supine position and the upper torso is bent at a nearly 85 degree position. The patient's head is secured by a restraint.
Prone position
Patient lies with stomach on the bed. Abdomen can be raised off the bed.
Jackknife position
Also called the Kraske position.[2] Patient's abdomen lies flat on the bed. The bed is scissored so the hip is lifted and the legs and head are low. [1][2]
Knee-chest position
Similar to the jackknife except the legs are bent at the knee at a 90 degree angle.
Lateral position
Also called the side-lying position, it is like the jackknife except the patient is on his or her side. Other similar positions are Lateral chest and Lateral kidney.
Kidney position
The kidney position is much like the lateral position except the patient's abdomen is placed over a lift in the operating table that bends the body to allow access to the retroperitoneal space. A kidney rest is placed under the patient at the location of the lift.[2]
Sims' position
The Sims' position is a variation of the left lateral position. The patient is usually awake and helps with the positioning. The patient will roll to his or her left side. Ke eping the left leg straight, the patient will slide the left hip back and bend the right leg. This position allows access to the anus.
There are various surgical positions during operations. OR nurses need to be equip with the knowledge which among these positions are appropriate during surgeries. Here are some quick guidelines for surgical positions:
o The OR nurse should check the table and gather all the necessary equipment to be used in the surgery before the patient enters the room.
o It is never a sin to ask for assistance
o Check with the anesthesia team before moving the patient.
o Do not forget your body mechanics
o Move the patient carefully. Remember, you need to keep the patient safe
o Watch out for IV lines, drains and other lines attach to the patient. You don’t want them pulled out right before surgery.
o Check the patient again once you have positioned him/her. Do not stare alone at the surgical site. Look at the patient as a whole.
Here are the most common Surgical Positions:
1. Supine or Dorsal Position
The legs are uncrossed, slightly apart and both arms are at the side or at the arm boards. The palms of the hands should be f acing the body to prevent
unnecessary muscle strain on the arms. This type of surgical position is used during the induction of general anesthesia, abdominal surgeries, open-
heartsurgeries, surgeries on neck, face and mouth, and most surgeries on extremities.
The following equipment are needed for this type of position: (1) pillow & padding materials (2) shoulder roll for modifications that require hyperextension
of the patient’s neck (3) padded footrest available for reverse trendelenburg.
There are also disadvantages or possible hazards which may include skin
breakdown, lumbar strains, circulatory compromise and nerve injury.
2. Prone Position
The patient is primarily positioned in supine and then log-rolled onto abdomen after the induction of anesthesia. The patient’s arms are either on the side
or at the arm boards. Those patients who are having surgery on the posterior part such as back or spine or at the back of his or her leg are placed in
prone position.
The following equipment are needed for this type of position: (1) chest rolls (2) pillows and padding materials (3) headrest or support of head.
Possible danger to the patient may include: skin breakdown, reduced respiration, eye or ear damage, reduced circulation, damage to breast or genitals
3. Modified Trendelenburg Position
The modified trendelenburg position is usually used for lower abdominal surgery to allow gravity to assist in maintaining the intestines in the upper part of
the abdominal cavity. This position is also used in lower extremity surgery to aid in hemostasis. The patient is positioned in supine position and the
operating table is slightly tilted in order for his head to be lower than his feet by 1-5 degrees.
4. Modified Reverse Trendelenburg Position
Modified Reverse Trendelenburg position is generally used for upper abdominal surgery and for the surgery of neck and face.This position allows improved operative exposure because gravity retains the int estines in the lower part of the abdomen.
5. Jackknife or Kraske Position
The patient is placed on supine position and log-rolled into abdomen. OR table is flexed approximately 90 degrees. Arms are placed at the side or at the arm boards. This position is almost exclusively used for rectal surgeries.
The equipment needed during the surgery is the same as that of the prone position, but there is a need for a wide adhesive tape.
6. Lithotomy Position

3. Positions
Supine position
The most common surgical position. The patient lies with back flat on operating room bed. [1][2][3]
Trendelenburg position
Same as supine position but the upper torso is lowered. [1][2]
Reverse Trendelenburg position
Same as supine but upper torso is raised and legs are lowered. [1][2]
Fracture Table Position
For hip fracture surgery. Upper torso is in supine position with unaffected leg raised. Affected leg is extended with no lower support. The leg is strapped at the ankle and the re is padding in the groin to keep pressure on the leg and hip. [1]
Lithotomy position
Used for gynecological, anal, and urological procedures. Upper torso is placed in the supine position, legs are raised and secured, arms are extended.
Fowler's position
Begins with patient in supine position. Upper torso is slowly raised to a 90 degree position.
Semi-Fowlers position
Lower torso is in supine position and the upper torso is bent at a nearly 85 degree position. The patient's head is secured by a restraint.
Prone position
Patient lies with stomach on the bed. Abdomen can be raised off the bed.
Jackknife position
Also called the Kraske position.[2] Patient's abdomen lies flat on the bed. The bed is scissored so the hip is lifted and the legs and head are low. [1][2]
Knee-chest position
Similar to the jackknife except the legs are bent at the knee at a 90 degree angle.
Lateral position
Also called the side-lying position, it is like the jackknife except the patient is on his or her side. Other similar positions are Lateral chest and Lateral kidney.
Kidney position
The kidney position is much like the lateral position except the patient's abdomen is placed over a lift in the operating table that bends the body to allow access to the retroperitoneal space. A kidney rest is placed under the patient at the location of the lift.[2]
Sims' position
The Sims' position is a variation of the left lateral position. The patient is usually awake and helps with the positioning. The patient will roll to his or her left side. Ke eping the left leg straight, the patient will slide the left hip back and bend the right leg. This position allows access to the anus.
This position is commonly used in operation requiring a perineal approach such as genito-urinal or gynecologic surgery. Patient is placed on supine position and both legs are lifted together into the stirrups.
You will need stirrups, stirrup holders and paddings for this surgical position. Possible hazards could be respiratory compromise, skin breakdown, nerve damage and muskuloskeletal injury.
7. Lateral Position
The lateral position is used for operations on the kidney, chest hips or lungs. The patient is positioned supine and then rolled into his side with the
operative side up. The top leg is straight and the bottom is flexed. Both arms are placed on the arm board with the upper arm on special arm support or
pillow. Head supported in alignment with the body.
You need bean bag or other stabilization device, pillows/any padding materials, axillary roll, and headrest/head support. Possible dangers could be skin
break down, nerve injury and reduced respiration.
8. Modified Fowler’s Position
The Modified Fowler’s position or the sitting position is mostly used
in neurosurgery. This position is used to facilitate surgical access to the cranium,
neck, or shoulder and to promote drainage from the surgical site.
Possible complications may include air embolism, pneumocephalus, nerve
damage, systemic hypotension, pressure ulcers, midcervical quadriplegia and
face, tongue or neck edema due to prolonged neck flexion.
There are so many more surgical positions, and modifications. It will all depend
on the surgeon’s preference which to place the patient. OR nurses should make
sure that whatever position the patient is placed, he or she is not compromised.
Here are the most common Surgical Positions:

4. Positions
Supine position
The most common surgical position. The patient lies with back flat on operating room bed. [1][2][3]
Trendelenburg position
Same as supine position but the upper torso is lowered. [1][2]
Reverse Trendelenburg position
Same as supine but upper torso is raised and legs are lowered. [1][2]
Fracture Table Position
For hip fracture surgery. Upper torso is in supine position with unaffected leg raised. Affected leg is extended with no lower support. The leg is strapped at the ankle and the re is padding in the groin to keep pressure on the leg and hip. [1]
Lithotomy position
Used for gynecological, anal, and urological procedures. Upper torso is placed in the supine position, legs are raised and secured, arms are extended.
Fowler's position
Begins with patient in supine position. Upper torso is slowly raised to a 90 degree position.
Semi-Fowlers position
Lower torso is in supine position and the upper torso is bent at a nearly 85 degree position. The patient's head is secured by a restraint.
Prone position
Patient lies with stomach on the bed. Abdomen can be raised off the bed.
Jackknife position
Also called the Kraske position.[2] Patient's abdomen lies flat on the bed. The bed is scissored so the hip is lifted and the legs and head are low. [1][2]
Knee-chest position
Similar to the jackknife except the legs are bent at the knee at a 90 degree angle.
Lateral position
Also called the side-lying position, it is like the jackknife except the patient is on his or her side. Other similar positions are Lateral chest and Lateral kidney.
Kidney position
The kidney position is much like the lateral position except the patient's abdomen is placed over a lift in the operating table that bends the body to allow access to the retroperitoneal space. A kidney rest is placed under the patient at the location of the lift.[2]
Sims' position
The Sims' position is a variation of the left lateral position. The patient is usually awake and helps with the positioning. The patient will roll to his or her left side. Ke eping the left leg straight, the patient will slide the left hip back and bend the right leg. This position allows access to the anus.
1. Supine or Dorsal Position
The legs are uncrossed, slightly apart and both arms are at the side or at the arm boards. The palms of the hands should be facing the
body to prevent unnecessary muscle strain on the arms. This type ofsurgical position is used during the induction of general anesthesia,
abdominal surgeries, open-heartsurgeries, surgeries on neck, face and mouth, and most surgeries on extremities.
The following equipment are needed for this type of position: (1) pillow & padding materials (2) shoulder roll for modifications that require
hyperextension of the patient’s neck (3) padded footrest available for reverse trendelenburg.
There are also disadvantages or possible hazards which may include skin breakdown, lumbar strains, circulatory compromise and nerve
injury.
2. Prone Position
The patient is primarily positioned in supine and then log-rolled onto
abdomen after the induction ofanesthesia. The patient’s arms are either
on the side or at the arm boards. Those patients who are having surgery
on the posterior part such as back or spine or at the back of his or her leg
are placed in prone position.
The following equipment are needed for this type of position: (1) chest
rolls (2) pillows and padding materials (3) headrest or support of head.
Possible danger to the patient may include: skin breakdown, reduced respiration, eye or ear damage, reduced circulation, damage to breast or genitals
3. Modified Trendelenburg Position
The modified trendelenburg position is usually used for lower abdominal surgery to allow gravity to assist in maintaining the intestines in the upper part of the abdominal
cavity. This position is also used in lower extremity surgery to aid in hemostasis. The patient is positioned in supine position and the operating table is slightly tilted in order
for his head to be lower than his feet by 1-5 degrees.
4. Modified Reverse Trendelenburg Position
Modified Reverse Trendelenburg position is generally used for upper abdominal surgery and for the surgery of neck and face.This position allows improved operative
exposure because gravity retains the intestines in the lower part of the abdomen.
5. Jackknife or Kraske Position
The patient is placed on supine position and log-rolled into abdomen. OR table is flexed approximately 90 degrees. Arms are placed at
the side or at the arm boards. This position is almost exclusively used for rectal surgeries.
The equipment needed during the surgery is the same as that of the prone position, but
there is a need for a wide adhesive tape.
6. Lithotomy Position
This position is commonly used in operation requiring a perineal approach such as genito-
urinal or gynecologic surgery. Patient is placed on supine position and both legs are lifted
together into the stirrups.
You will need stirrups, stirrup holders and paddings for thissurgical position. Possible
hazards could be respiratory compromise, skin breakdown, nerve damage and
muskuloskeletal injury.

5. Positions
Supine position
The most common surgical position. The patient lies with back flat on operating room bed. [1][2][3]
Trendelenburg position
Same as supine position but the upper torso is lowered. [1][2]
Reverse Trendelenburg position
Same as supine but upper torso is raised and legs are lowered. [1][2]
Fracture Table Position
For hip fracture surgery. Upper torso is in supine position with unaffected leg raised. Affected leg is extended with no lower support. The leg is strapped at the ankle and the re is padding in the groin to keep pressure on the leg and hip. [1]
Lithotomy position
Used for gynecological, anal, and urological procedures. Upper torso is placed in the supine position, legs are raised and secured, arms are extended.
Fowler's position
Begins with patient in supine position. Upper torso is slowly raised to a 90 degree position.
Semi-Fowlers position
Lower torso is in supine position and the upper torso is bent at a nearly 85 degree position. The patient's head is secured by a restraint.
Prone position
Patient lies with stomach on the bed. Abdomen can be raised off the bed.
Jackknife position
Also called the Kraske position.[2] Patient's abdomen lies flat on the bed. The bed is scissored so the hip is lifted and the legs and head are low. [1][2]
Knee-chest position
Similar to the jackknife except the legs are bent at the knee at a 90 degree angle.
Lateral position
Also called the side-lying position, it is like the jackknife except the patient is on his or her side. Other similar positions are Lateral chest and Lateral kidney.
Kidney position
The kidney position is much like the lateral position except the patient's abdomen is placed over a lift in the operating table that bends the body to allow access to the retroperitoneal space. A kidney rest is placed under the patient at the location of the lift.[2]
Sims' position
The Sims' position is a variation of the left lateral position. The patient is usually awake and helps with the positioning. The patient will roll to his or her left side. Ke eping the left leg straight, the patient will slide the left hip back and bend the right leg. This position allows access to the anus.
7. Lateral Position
The lateral position is used for operations on the kidney, chest hips or lungs. The patient is positioned supine and then rolled into his
side with the operative side up. The top leg is straight and the bottom is flexed. Both arms are placed on the arm board with the upper
arm on special arm support or pillow. Head supported in alignment with the body.
You need bean bag or other stabilization device, pillows/any padding materials, axillary roll, and headrest/head support. Possible
dangers could be skin break down, nerve injury and reduced respiration.
8. Modified Fowler’s Position
The Modified Fowler’s position or the sitting position is mostly used in
neurosurgery. This position is used to facilitate surgical access to the
cranium, neck, or shoulder and to promote drainage from the surgicalsite.
Possible complications may include air embolism, pneumocephalus,
nerve damage, systemic hypotension, pressure ulcers, midcervical
quadriplegia and face, tongue or neck edema due to prolonged neck
flexion.
There are so many more surgical positions, and modifications. It will all
depend on the surgeon’s preference which to place the patient. OR nurses should make sure that whatever position the patient is placed, he or she is not compromised.

6. Positions
Supine position
The most common surgical position. The patient lies with back flat on operating room bed. [1][2][3]
Trendelenburg position
Same as supine position but the upper torso is lowered. [1][2]
Reverse Trendelenburg position
Same as supine but upper torso is raised and legs are lowered. [1][2]
Fracture Table Position
For hip fracture surgery. Upper torso is in supine position with unaffected leg raised. Affected leg is extended with no lower support. The leg is strapped at the ankle and the re is padding in the groin to keep pressure on the leg and hip. [1]
Lithotomy position
Used for gynecological, anal, and urological procedures. Upper torso is placed in the supine position, legs are raised and secured, arms are extended.
Fowler's position
Begins with patient in supine position. Upper torso is slowly raised to a 90 degree position.
Semi-Fowlers position
Lower torso is in supine position and the upper torso is bent at a nearly 85 degree position. The patient's head is secured by a restraint.
Prone position
Patient lies with stomach on the bed. Abdomen can be raised off the bed.
Jackknife position
Also called the Kraske position.[2] Patient's abdomen lies flat on the bed. The bed is scissored so the hip is lifted and the legs and head are low. [1][2]
Knee-chest position
Similar to the jackknife except the legs are bent at the knee at a 90 degree angle.
Lateral position
Also called the side-lying position, it is like the jackknife except the patient is on his or her side. Other similar positions are Lateral chest and Lateral kidney.
Kidney position
The kidney position is much like the lateral position except the patient's abdomen is placed over a lift in the operating table that bends the body to allow access to the retroperitoneal space. A kidney rest is placed under the patient at the location of the lift.[2]
Sims' position
The Sims' position is a variation of the left lateral position. The patient is usually awake and helps with the positioning. The patient will roll to his or her left side. Ke eping the left leg straight, the patient will slide the left hip back and bend the right leg. This position allows access to the anus.