Surgeons' perspectives on optimal patient positioning during simultaneous cranial procedures and exploratory...

Area of Science:

• Trauma Surgery
• Neurosurgery
• Surgical Positioning

Background:

• Simultaneous traumatic intracranial and intraabdominal injuries necessitate emergent care.
• Optimal patient positioning for combined neurosurgical and general surgical procedures can cause delays, negatively impacting patient outcomes.
• Current positioning strategies may not adequately address the needs of simultaneous multi-system trauma surgery.

Purpose of the Study:

• To determine an optimal operative patient position for simultaneous neurosurgical and general surgical access.
• To evaluate a hybrid position that maintains sterility and surgeon comfort.
• To reduce delays in emergent care for patients with combined injuries.

Main Methods:

• Surgeons evaluated traditional (A, B) and a novel hybrid (C) patient positions.
• 29 general surgeons and 12 neurosurgeons participated in the study.
• Positions were rated for acceptability and ranked by preference for simultaneous procedures.

Main Results:

• The hybrid position (C) was acceptable to 82.8% of general surgeons and 100% of neurosurgeons.
• A significant majority preferred the hybrid position: 51.9% of general surgeons and 81.8% of neurosurgeons.
• Position C demonstrated high acceptability and preference for combined surgeries.

Conclusions:

• A novel hybrid operative position facilitates simultaneous exploratory laparotomy and craniotomy.
• This position optimizes access for both surgical teams without compromising sterility or comfort.
• Collaboration between trauma and neurosurgery is crucial for managing complex trauma patients.