The fully prone position, once used in surgery for chronic inflammatory lung diseases, has become obsolete. In the last 2 years, a modified semiprone position was used for video-assisted thoracoscopic surgery in 358 patients undergoing lobectomy with mediastinal complete lymphadenectomy The ports were placed with the patient in the lateral decubitus position. The patient was rotated 45–60 degrees towards the surgeon, giving enhanced exposure of the posterior mediastinum, esophagus, subcarinal and paratracheal spaces, due to displacement of the lung under gravity away from the operative field. This position is safe, well-tolerated, and allows more ergonomic and anatomical placement of the ports.
CuschieriAShimiSBantingS. Endoscopic oesophagectomy through a right thoracoscopic approach. J R Coll Surg Edinb1992;37:7–11.
2.
PalaniveluCPrakashASenthilkumarRSenthilnathanPParthasarathiRRajanPSMinimally invasive esophagectomy: thoracoscopic mobilization of the esophagus and mediastinal lymphadenectomy in prone position—experience of 130 patients. J Am Coll Surg2006;203:7–16.
3.
PelosiPTubioloDMascheroniDVicardiPCrottiSValenzaFEffects of the prone position on respiratory mechanics and gas exchange during acute lung injury. Am J Respir Crit Care Med1998;157:387–93.
4.
GattinoniLTognoniGPesentiATacconePMascheroniDLabartaVEffect of prone positioning on the survival of patients with acute respiratory failure. N Engl J Med2001;345:568–73.
5.
EdgcombeHCarterKYarrowS. Anaesthesia in the prone position. Br J Anaesth2008;100:165–83.
6.
ChoKTLeeHJ. Prone position related meralgia paraesthesia after lumbar spine surgery: a case report and review of the literature. J Korean Neurosurg Soc2008;44:392–5.
