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Today we're going to be talking about draping a patient in
lithotomy position. Draping a patient in lithotomy position is one of those
skills that is extremely scary for new people because we have a couple of
unique drapes, we are so close to the patient, it becomes easy to contaminate
very easy to contaminate, in fact. First let's talk about those unique drapes. The
first two drapes that are pretty unique are the under buttocks drape and the
leggings drapes. These drapes have put fear into the hearts of many a student
and new employees. But I think that with a couple of practices we can overcome
our anxiety and see that it's not that hard. We also have towels, medium sheets,
and a fenestrated drape. There are many cool fenestrated drapes out there that
are specific to lithotomy position and do the best job of covering the patient.
But as I don't possess one of those in the lab I'm stuck with a regular
laparotomy drape. So here we go. The surgeon has walked into the room, we have
gowned and gloved them, and we are ready to drape. I have my good friend Charlie
the Mannequin up in lithotomy position. I love him for doing that so it means
that I don't have to be up in lithotomy position. So what's first. Well I've seen
two methods. The first method is that, and the one described in the textbook, and
the one I'm going to demonstrate, is to place the under buttocks drape first.
The second method, and the one I actually like, is placing the leggings first. Now
the reason I like the idea of placing the leggings first is because I've seen
many Techs use the under buttocks drape first and
I've seen most of them contaminate themselves on the stirrups. Years ago
when we used candy-cane stirrups, when they were common, it wasn't such a big
deal because the leg was more vertical and out of the way. But now with
adjustable stirrups being utilized it's far easier
to contaminate your gown. So I think leggings should go first.
But I'm gonna put the under buttocks drape first. So manufacturers continue
to do a great job for us by telling us where to place our hands. So with my
hands underneath the cuff of the under buttocks drape, I'm gonna place the drape
completely under the buttocks, so that only the cuff is barely visible
underneath the patient. I'm gonna be sure to be very careful and make sure that I
am careful not to contaminate my sleeves on the stirrups. So I've got the under
buttocks drape. It says left hand and right hand. How amazing is that. I'm gonna
let the drape completely fall. Left hand, right hand, I'm gonna be careful not to
contaminate and I'm gonna push it under the patient. There you go. Next we're
gonna grab two towels that have been prepared ahead of time and we're going
to outline the surgical site. One drape to my surgeon, one drape for me. Alright.
Now the great thing is that the companies and the manufacturers that
make these drapes make it as easy as possible. They are kind enough to label
the direction of the drape, the side it's supposed to be on, and often times the
anatomy it covers. So here we see on the leggings. It says left hand under the
cuff and toe. So I'm going to go ahead and follow those directions and put my
left hand under the cuff. I'm also gonna grab my right hand on the toe and let
the drape drop. Now it is incredibly easy to not put this drape on correctly. So we
want to start initially really, really well, and take our time at the beginning
so that we're sure to cover the whole stirrup. So with the toe in my right hand
I'm gonna go under the cuff and try and create an opening. Then I'm going to
slowly put the drape onto the stirrup, staying behind the cuff,
pulling the toe. Again this is not easy. Then I'm going to extend it on to the
patient, just like that. The next drape. Again left hand under the
cuff and toe. So I'm going to put my hand there, grab the toe, I'm gonna
continue to put my, and I'm gonna put my right hand under. And again it's
important to go slow and stay behind the cuff so that we get it completely on the
stirrup and we don't contaminate. There we have it. Not too shabby.
Now when I think the stirrups are completely covered and I've extended the
drapes on there I'm gonna go ahead and start and put a medium sheet on the
patient. We're gonna make a cuff and drop. And then lastly we have the fenestrated
drape. Again, I only have a laparotomy drape but there are other drapes out
there that will completely cover the patient. Patient's head. Patient's body. I'm
gonna put the hole right in the incision site, extend it to my surgeon, we're gonna
create a cuff, go down. Completely extend the drape. Create a cuff and go forward.
And there we have it folks. A completely draped patient in lithotomy position. At
this point I would pull my table up, throw off my cords, and we would begin
the procedure. I'm Mike from Surgtech Academy signing off and wishing you a
great day in surgery and reminding you to be a superstar in your O.R.