Gynaecological Surgery
Extensive gynaecological surgery often entails meticulous dissection near the bladder, rectum, ureters, and great vessels of the pelvis. Complications of gynaecological surgery include haemorrhage, infection, thromboembolism, and visceral damage. To reduce the risk of complications the surgeon needs to gain easy and precise access to the pelvic region and ensure they have good visibility at all times.
Reducing the risk of cross infection entails easy and quick to clean products with no areas to potentially harbour infections. During gynaecological surgery the use of sterile disposable equipment reduces the risk of cross infection; however it is the carers’ responsibility to ensure the cleanliness of the environment between patients. We know that gram-negative micro-organisms can survive for a long time on surfaces in the hospital and can enter the body through wounds, catheters, and especially invasive surgical procedures. The important responsibility of cleaning between patients should be made as easy as possible to prevent any risk, and must be a key consideration in any design.
Lithotomy position
It is well documented that the recommended practices for positioning the patient in the lithotomy position to enhance safety and prevent injury is as follows:
Use adjustable and well-fitting stirrups, place stirrups at an even height , position the bottom so the sacrum is securely supported on the surface. Lift the patient's legs slowly and simultaneously into the leg holders to prevent lumbosacral strain. Place the heels in the lowest possible position, provide support for the largest surface area of the leg. Protect the patient's legs to ensure that they do not rest against the stirrup posts.
All these guidelines are taken into account during product developement.
Pressure Relief and comfort
The lithotomy position by the very nature of the position can cause some real forces on the skin. Pressure on the sacral area due to a reduced surface area as well as increased pressure exertion resulting from the upwards position and weight of the patients legs.
Shear forces will be created if the patient slips or if an unnatural head up position is assumed; this is most definitely the case in a non-electric table. With no electric backrest the patient will try and pull herself up as she slides causing trauma by shear as she does so.
Artificial insemination
Infertility affects millions of women around the world. Infertility can be brought on by any number of reasons and conditions, from emotional to physical factors. The incidence of fertility in women can vary largely, and in most cases can be treated. An estimated 10 to 20 percent of couples will suffer some form of infertility most of whom will seek treatment which will lead to artificial insemination.
During artificial insemination precise positioning of the patients pelvis is required to ensure sperm reaches the uterus - a lithotomy position is adopted with hips slightly boosted, slow manipulation of this hip position may often be required during the insemination process.
It is documented also in the British Medical Journal, that after undergoing IUI (intrauterine insemination) as a treatment for subfertility, women allowed to remain in supine position will yield a 50 percent higher chance of conceiving."
Key considerations in product design
We incorporate cleanable surfaces reducing the areas to harbour micro-organisms, we add an easy to achieve lithotomy position with intuitive and easy to use stirrups, we add multiple easy to achieve position changes including foot positioning for maximum comfort and safety. We focus on a comfortable, conformable surface to reduce the risk of skin damage and add a feature to allow the user to choose a predefined position quickly and easily.