The jackknife position provides visibility of the anorectal area, so it’s commonly used during proctologic procedures, including anorectal and colorectal surgeries, such as when parts of the colon, rectum, and anal sphincter are removed. The jackknife position also allows the surgeon to have improved handling of surgical instruments while maintaining ergonomic posture during a procedure where it may be difficult to reach the surgical field. The improved visibility and handling of surgical instruments can help minimize the duration of these surgical procedures. Further, this positioning also uses hip flexion to help decrease intra-abdominal pressure, which can minimize bleeding at the surgical site.
Additionally, this position may be used during certain spinal surgeries, such as a lumbar discectomy, as it allows for greater accessibility of the spine. However, it can be associated with a risk of postoperative neurological symptoms like neurapraxia, which is a mild form of peripheral nerve injury that causes temporary weakness and burning in the lower extremities. To avoid nerve damage, the head, arms, and legs are supported with straps and appropriate padding.
There are several factors that can limit the use of the jackknife position, including physical factors, like pregnancy or obesity, and orthopedic factors, like knee or joint problems. The jackknife position can also affect both the cardiovascular and respiratory systems causing a decreased vital capacity and lung compliance related to restricted diaphragmatic movement. Therefore, it may be avoided in individuals with comorbid conditions affecting the heart, blood vessels, and lungs or if there are any concerns for maintaining the patient’s airway. In such cases, a variant of the jackknife position, known as the lateral jackknife position, can be used. This position offers good access to areas such as the rectum, anus, and perineum, similar to the traditional jackknife position, but with less strain on the respiratory system and better circulatory support.
