© Springer France 2014
Dominique G. Poitout and Henri Judet (eds.)Mini-Invasive Surgery of the Hip10.1007/978-2-287-79931-0_44. Smith-Petersen Approach and Lateral Position with Mini-Stem
(1)
Professeur des Universités, Service de chirurgie et de traumatologie, CHU de Marseille – Hôpital Nord, 13015 Marseille, France
Abstract
The Smith-Petersen approach permits a less invasive hip arthroplasty by not cutting the surrounding muscles of the hip.
The lateral position of the patient induces an easy exteriorisation of the upper part of the femur.
The use of the mini-stem permits an easy introduction of the stem inside the upper part of the femur.
There are few risks using this type of approach which can be less than 8 cm.
Keywords
Total hip arthroplastySmith-Petersen approachLateral positionMini-stemIntroduction
The Smith-Petersen approach permits a less invasive hip arthroplasty by not cutting the surrounding muscles of the hip.
The lateral position of the patient induces an easy exteriorisation of the upper part of the femur.
The use of the mini-stem permits an easy introduction of the stem inside the upper part of the femur.
There are few risks using this type of approach which can be less than 8 cm.
Material and Method
Patient Installation
Before entering the operation theatre, all the hairs are cut off and the skin prepared with Betadine1 1 (if no allergy).
The patient is placed in a strict lateral position.
The sacrum is supported posteriorly.
Another support is installed interiorly against the pubis.
The contralateral arm is extended over an armrest, and a silicone pad is placed transversally under the axilla and along the contralateral leg which is also fixed to the table with Elastoplast.
After preparing the surgical field, impervious and strong nonwoven (paper) drapes are placed on the patient.
Two drapes are placed under the limb to be operated on. The first drape is made of plastic, and the second one, made of impervious and strong paper, is fixed transversally with adhesive tape and then extends upwards to cover both aspects of the root of the thigh.
Two lateral drapes cover the sides of the operating table, and one upper drape isolates the patient from the anaesthesiologist.
A limb bag is fixed to the front end of the anterior drape. The operated limb is sheathed in an impervious sock which allows for the free movement of the limb.
An opposite film is applied on the surgical field.
Surgeons Position
The surgeon stands behind the patient; the first assistant stands on the opposite side; a second assistant stands to the right of the surgeon (if the surgery is performed on the left hip) or to the left (if the surgery is performed on the right hip). The second assistant stands between the surgeon and the drapes isolating the patient from the anaesthesiologist.
The scrub nurse stands opposite to the second assistant with the instrument table facing her.
Incision
The incision is marked by a line measuring 8 cm and running at 1 cm in front of the greater trochanter and over it. It is slightly curved forward (20°) in its upper portion.
Incision of the skin and subcutaneous tissues is followed by haemostasis.
Related posts:
Mini-Invasive Approach and Navigation in Total Prosthesis of the Hip
Hip Resurfacing and Anterior Approach
Transtrochanteric Approach to the Hip
Anterior Approach for Total Hip Arthroplasty: Technique Without Fracture Table
Minimally Invasive Posterior Approach: Technical Evaluation, Initial Results and Follow-Up at Two Years
Navigation and the Square Angle Pointer in Hip Resurfacing
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