ABSTRACT
The patient should be supine. The Lloyd-Davis (lithotomy-Trendelenburg) position is required for AP resections. Good muscle relaxation and soft undistended bowel aid surgery.
Anaesthetic implications
? Patient position: the Lloyd-Davis position involves placing the patient’s legs in multi-jointed leg supports with the patient placed head-down. The hips are less flexed than the standard lithotomy position and access is improved by abducting the thighs. The calves should be well supported and the legs held in the supports in such a way as not to cause adverse pressure effects. Extra care should be taken with patients with arthritic hips. For surgery other than AP resections, head-down positioning is often required to reduce the amount of small bowel in the surgical site (see also Chapter 3).
