ABSTRACT
Surgical Positioning The photograph and drawing in this figure demonstrate standard surgical positioning for a carotid endarterectomy (CEA). The patient is positioned with the head extended and turned somewhat to the opposite side from the proposed surgical incision. The degree of head turning depends on the relationship of the internal and external carotid arteries, whether side-by-side or conventional in position as outlined in Fig. 2-3, Radiographic studies, it will be turned more for a “side-by-side” carotid exposure. The head is allowed to fall back on a foam donut, and five or six folded towels or pillowcases are placed between and beneath the patient’s shoulder blades, thereby permitting the shoulders to drop back, away from the surgical field. If this is not done, the surgeon will need to work over the bony shoulder prominence, which is awkward.
