In what position should a patient be placed for a laparoscopic vaginal hysterectomy?

For a laparoscopic vaginal hysterectomy, the appropriate position for the patient is the low lithotomy position. This positioning allows for optimal access to the vaginal canal, enabling the surgeon to perform the procedure effectively. The low lithotomy position elevates the legs and provides a stable platform, which facilitates both the laparoscopic and vaginal components of the surgery by improving visibility and access to the pelvic organs.

While other positions like supine or Trendelenburg may be used in specific surgical contexts, they do not provide the same benefits as the low lithotomy position for this particular type of surgery. The supine position is primarily used for abdominal surgeries but lacks the necessary access for vaginal procedures. Trendelenburg positioning, which tilts the patient’s body with the head down, might be considered in some surgeries to enhance venous return but is not suitable for a laparoscopic vaginal hysterectomy due to the need for direct access to the pelvic area. The sitting position is generally not appropriate for this procedure as it does not provide the necessary exposure and access. Thus, the low lithotomy position is the optimal choice for ensuring effective surgical access and safety during a laparoscopic vaginal hysterectomy.