“Perioperative team members should implement measures to prevent patients from sliding on the OR bed (in Steep Trendelenberg),” the revised AORN Guidelines stress, specifically mentioning viscoelastic gel overlays (Page E31, X.f.1).

“Adequate patient positioning must avoid skin, peripheral nerve, and muscles injuries, and ocular and cognitive complications mainly related to Steep Trendelenburg positioning in pelvic procedures,” sciencedirect.com cautions. 

In any surgery, proper patient positioning on the operating table is paramount for:

  • Optimal surgical exposure
  • Prevention of neuromuscular injury
  • Accommodating the camera system and arms
  • Reducing physician fatigue

To enable these results, robot-assisted surgery is typically performed with the patient placed in the steepest possible Trendelenburg position with the feet elevated 30-45% relative to the head. The Trendelenburg position is particularly advantageous for abdominal, urological, and gynecological surgery in that it allows better access to pelvic organs.

In addition to the special dangers presented by Trendelenburg positioning of the body, including neuromuscular injury, cardiac arrhythmias, and ocular trauma, there is increased risk of slippage.

Positioning products are intended to mitigate both the risks of pressure injuries and the risk of slippage. In speaking with operating room nurses across the country, Rochelle Froloff, R.N. of Action Products found nurses recommending the O.R. gel Overlay on top of the primary support operating table pad.  The overlay provides comfort with minimized patient movement and maximized pressure distribution. One step further is the OR Table Pad, exclusively manufactured by Action, which comes in two styles, Original and Performance Plus. The pads have a 360-degree stretch surface for minimal shearing. 

The use of robotic assistance in surgery has expanded exponentially since it was first approved in 2000, explains the U.S. Department of Health & Human Services. “Robotic surgical systems have the potential to improve surgical technique and outcomes, but they also create a unique set of risks and patient safety concerns.” “Positioning is even more critical in robotic surgery because it must provide access to the surgical field and also accommodate the robotic camera system and working arms,” Contemporary OBGYN comments.  

Meanwhile, as the revised Guidelines emphasize, perioperative team members should implement measures to prevent patient from sliding on the OR bed. Using Action® viscoelastic gel polymer overlays can help.