Draping a patient in lithotomy position


Hello everybody and welcome to Surgtech Academy. I want to remind you that if you haven’t already, please subscribe
to my channel for the latest videos and notifications. 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.