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The supine position (/ˈsuːpaɪn/) means lying horizontally with the face and torso facing up, as opposed to the prone position, which is face down. When used in surgical procedures, it grants access to the peritoneal, thoracic and pericardial regions; as well as the head, neck and extremities.^[1]

Using anatomical terms of location, the dorsal side is down, and the ventral side is up, when supine.

The lithotomy position is a common position for surgical procedures and medical examinations involving the pelvis and lower abdomen, as well as a common position for childbirth in Western nations. The lithotomy position involves the positioning of an individual's feet above or at the same level as the hips (often in stirrups), with the perineum positioned at the edge of an examination table. References to the position have been found in some of the oldest known medical documents including versions of the Hippocratic oath (see lithotomy); the position is named after the ancient surgical procedure for removing kidney stones and bladder stones via the perineum. The position is perhaps most recognizable as the 'often used' position for childbirth: the patient is laid on the back with knees bent, positioned above the hips, and spread apart through the use of stirrups.

The position is frequently used and has many obvious benefits from the doctor's perspective. Most notably the position provides good visual and physical access to the perineal region. The position is used for procedures ranging from simple pelvic exams to surgeries and procedures including those involving reproductive organs, urology, and gastrointestinal systems. New observations and scientific findings, combined with a greater sensitivity to patient needs have raised awareness of the physical and psychological risks the position may pose for prolonged surgical procedures, pelvic examinations, and, most notably, childbirth.

Lateral position

The lateral position, also known as the lateral decubitus or lateral recumbent position, is one of the four main surgical patient positions. It involves the patient lying on one side, with the operative side up, allowing for surgical access to one side of the body.

Benefits and Applications

The lateral position is commonly used for:

• Thoracic surgeries
• Surgeries involving retroperitoneal structures (e.g., kidneys, adrenal glands, pancreas, nerve roots, lymph nodes, abdominal aorta, and inferior vena cava)
• Surgeries of the hip
• Non-surgical procedures, such as lumbar punctures and peripheral nerve blocks (e.g., lumbar plexus block)

Key Considerations

• Proper alignment and support of extremities are crucial in the lateral position
• The patient’s physiologic spinal and neck alignment should be maintained during the procedure
• A safety restraint should be secured across the patient’s hips
• The lateral position may be used with either the left or right side up, depending on the surgical site

Importance of Proper Patient Positioning

Proper patient positioning is essential for optimal surgical access, patient safety, comfort, and overall procedural success. The lateral recumbent position is a versatile and effective option for various medical and surgical scenarios, requiring thoughtful consideration to maximize its benefits while minimizing potential risks.