General considerations

The operating theatre is a hazardous environment for all persons. When a patient is given a general anaesthetic they lose all ability to protect and fend for themselves. As a consequence, all staff within the operating department must take over this protective function, and they have a responsibility to ensure that every patient is safe. Good clinical practice is required to ensure that the safety of all manoeuvres performed in theatre (such as a transfer or the achievement of a surgical position) is constantly appraised and audited to maintain good standards.

The surgeon is ultimately responsible for patient safety in this environment, and is the usual focus for medicolegal issues when things go wrong. The achievement of an adequate and safe surgical position to perform an operation is only one small part of their overall responsibility. The surgeon usually takes an active role in positioning a patient as it can facilitate the operation. It is appropriate to outline the surgeon's other responsibilities to a particular patient undergoing surgery.