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[The ventrolateral position].

J Guarnieri1, J-M Derlon, J-P Houtteville

  • 1Service de Neurochirurgie, CHU, avenue de la Côte-de-Nacre, 14033 Caen Cedex. guarnieri-j@chu-caen.fr

Neuro-Chirurgie
|June 24, 2004
PubMed
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The novel ventrolateral position offers a safe and effective alternative to the sitting position for neurosurgery. This technique provides excellent surgical access and avoids the risks of air embolism, enhancing patient safety.

Area of Science:

  • Neurosurgery
  • Surgical Positioning
  • Patient Safety

Context:

  • The sitting position is advantageous for posterior fossa surgery but carries risks like air embolism.
  • Existing horizontal positions may not offer the same surgical access or safety profile.
  • A need exists for an alternative position that combines the benefits of the sitting position with enhanced safety.

Purpose:

  • To introduce and evaluate a ventrolateral decubitus position as a safe alternative to the sitting position in neurosurgery.
  • To maintain the surgical advantages of the sitting position while mitigating the risk of air embolism.
  • To assess the feasibility and safety of this position for various cranial and cervical procedures.

Summary:

  • The ventrolateral position, with the patient laterally recumbent and head supported by a Mayfield holder, was used in 556 neurosurgical cases.

Related Experiment Videos

  • This position provided effective surgical access to posterior cranial fossa (81.3%), supratentorial (12.75%), and cervical (4.7%) lesions.
  • No instances of air embolism or capnographic anomalies were reported, regardless of patient morphology.

    • Impact:

    • The ventrolateral position successfully replaced the sitting position in the institution, demonstrating broad applicability.
    • It facilitates access to a wide range of lesions, from the cervical spine to the supratentorial region.
    • The position is compatible with anesthetic and surgical requirements, offering a safe and versatile option for neurosurgeons.