if patient is that heavy will probably be too heavy for table; follow IPSIS guidelines for best results - shortcuts lead to bad outcomesI oblique 10 to the left, then once placed I oblique 10 to the right and they to get my target points on the right lined up, plus the needle tips on the left to verify position from a second angle. Even if they looked great in the first view the second does often show them to be a little too shallow or too inferior.