How to Position the Patient in Lithotomy Stirrups

Today, we will guide you through the proper technique for positioning a patient in lithotomy stirrups. This process is of utmost importance in ensuring patients' safety and comfort during medical procedures requiring the patient to be placed in the lithotomy position. In this demonstration, we will utilize KYRA® Comfort 350™ Lithotomy Stirrups. 

Importance of Proper Positioning

Positioning a patient in lithotomy stirrups is crucial for medical procedures to ensure comfort, safety, and effectiveness. Proper positioning is essential to prevent injury, protect at-risk areas such as the peroneal nerve, and provide optimal access to the surgical site. It requires careful attention to detail and a coordinated effort between the medical team members involved.

Two-Person Procedure

Due to the precision required, positioning a patient in lithotomy stirrups is typically a two-person job. This approach ensures that the legs are moved into the stirrups as a mirror image, preventing uneven pressure distribution on the hips and reducing the risk of hip dislocation.

Key Steps in Positioning

• Assess the Equipment: Ensure the lithotomy stirrups have an appropriate weight capacity to accommodate the patient and that all parts are in working condition.  
• Align the Patient on the Table: Start by positioning the patient at the lithotomy end of the table with the cutout, aligning the hips with the edge of the table.  
• Prepare the Stirrups: Securely attach the stirrups to the rails, ensuring the ball joint matches the patient's hip joint for optimal positioning. Tighten the clamp to secure it to the rail. 
• Align the Patient’s Legs: Match the back of the patient's leg with the back of the stirrup, adjusting the stirrup angle to 30 degrees for stability. Adjust the boot stirrup so it matches the imaginary line running from the patient’s toe, through the knee, to the opposite shoulder. This is called TKO (toe-knee-opposite shoulder) alignment.  
• Position the Patient’s Ankles: Ensure the patient's ankle is fully seated in the stirrup boot to prevent slippage during the procedure.  
• Make Final Adjustments: Once the patient's legs are securely positioned in the stirrups, check the alignment of the hip, ankle placement, and stirrup angle to guarantee stability.  
• Secure the Stirrups: Use the secure lock straps to fasten the top flap over the patient’s leg, maintaining a secure yet comfortable fit for the patient. Ensure all three straps are used, and listen for the audible noise to confirm they are secure. Do not overtighten the straps. 
• Adjust the Lithotomy Angle: Raise or lower the stirrups to adjust the patient to the required position for the procedure, anywhere from high lithotomy to low lithotomy. 

Properly positioning a patient in lithotomy stirrups is a critical aspect of various medical procedures, particularly in urology and gynecology. By following the outlined steps and emphasizing symmetry and alignment, healthcare providers can help ensure patient safety and provide optimal access to the surgical site, contributing to procedural success.

Want to learn more? Browse our full line of KYRA surgical table accessories and explore our additional resources on surgical patient positioning:  

• KYRA Medical Surgical Table Accessories 
• KYRA Medical Videos 
• Surgical Positioning Guide 
• Operating Room Interactive Room Guide 
• Patient Positioning Blogs