When you place patients head down with their stirrup-supported legs reaching skyward at a 30- to 45-degree angle, there is a laundry list of things that could go wrong, ranging from sheering injuries and problematic sliding to potentially blinding intraocular pressure injuries. While there are certainly many inherent dangers to steep Trendelenburg, the shifting of organs and neurovascular structures provides adequate visualization of key areas of the patient’s anatomy surgeons need to perform surgery.
With the increased use of less-invasive surgical procedures, strategic patient positioning such as steep Trendelenburg is only likely to be more commonplace in outpatient facilities — especially in those that use robotics. It’s therefore essential to ensure adequate planning takes place, positioning aids are available and regular monitoring occurs whenever patients are placed in the position.