by Lanier Norville
Surgical patient positioning devices have advanced tremendously in the last few decades, to the point that they can now actively improve surgical outcomes, according to Earl Cole, vice president Innovative Medical Products, which in 1984 came out with the Maguire Pelvic Positioner, the first true hip positioner designed to hold a patient in a lateral position.
The company has worked with orthopedic surgeons to create positioning systems for orthopedic hip, knee and ankle surgery, and is currently developing a tower system for wrist surgery. Cole says the No. 1 goal of IMP’s products is to improve surgical outcomes by offering the potential to reduce procedure time. The DeMayo RoTractor, for example, secures the patient’s arm rotation during arthroscopic shoulder surgery. “With the RoTractor, the surgical staff gains an extra pair of hands,” Cole says.
Cole says that since the Centers for Medicare and Medicaid Services (CMS) deemed pressure ulcers a “never event,” the market has grown for patient positioners that can reduce pressure on the skin during surgery. Cole says IMP’s projections show expected growth of 8 or 9 percent in 2013. With more facilities focusing on patient satisfaction, the popularity of products that can minimize post-operative pain has increased. Improper positioning increases the risk of post-operative complications such as respiratory problems, impaired circulation, and nerve, muscle and skin trauma, all of which can both decrease patient satisfaction and increase costs for the facility.
The increasing prevalence of robotic surgery systems, and the new techniques and procedures they allow, has spurred rapid growth in the patient positioner market. More specific procedures require more specific positioners, a reality that has made patient positioners both more necessary and more expensive. Though a handful of manufacturers currently dominate robotic surgery, “others are positioning themselves to start selling their systems, which means it’s going to be that much more important that patient positioners are as stable as possible,” Cole says.
Robotic surgery systems allow smaller incisions and more precise movements, so positioning that is even a few centimeters off can negatively impact outcomes. “When a patient is in a lateral position and there is any kind of movement, that could impact the results,” he says. In orthopedic surgery, that could mean a bone is not sculpted as exactly as it needs to be, or an implant could potentially be misplaced, Cole says. And as the average patient weight continues to increase, proper stabilization is more important than ever.
To achieve the maximum benefits patient positioners offer, communication among surgical team members is key. Training from both the sales representative and among the surgical team after purchase is key for today’s more specific positioners, Cole says.
According to the Association of periOperative Registered Nurses (AORN) guidelines, “The procedure, surgeon preference and patient condition determine equipment used for positioning. Working as a member of the team, the perioperative nurse can minimize the risk of perioperative complications related to positioning.”