Laparoscopy To examine peritoneal cavity and its viscera

Laparoscopy To examine peritoneal cavity and its viscera A type of endoscope, called a laparoscope, is placed through a small _______ in the skin of the ventral abdomen Can be midline or opening into the abdominal wall (lateral to midline) What was the other type of endoscopy that requires an incision? Necessary equipment Laparoscope Trocar Cannula Fiber-optic light cable Light source Veress insufflation needle Gas insufflator and hose Camera/video system (optional)

Laparoscopy: Advantages

Laparoscopy: Contraindications

Laparoscopic Equipment Laparoscope Come in various sizes Rigid, metal tube with a light port Can also have an instrument port Cannot be autoclaved

Laparoscopic Equipment Gas insufflator Machine that allows a gas to continuously expand the abdominal cavity Required for better visualization of the viscera Other parts needed: insufflation needle, sterile hose, and gas cylinder _______ – the recommended gas due to rapid absorption • Flow rate of Nitrous oxide and room air are also options (not common) Must monitor intra-abdominal pressure! Not to exceed _______ *Tubing is connected from the gas insufflator to the Veress needle.

Gas Insufflator

Laparoscopic Equipment Trocar–cannula units Sharp trocar (inside of the cannula) punches through the abdominal wall Sharp trocar can be replaced with a blunt trocar or the laparoscope Cannula is left in place

Laparoscopic Equipment Veress insufflation needle Used during insufflation of the peritoneal cavity Needle pierces through abdominal layers, into peritoneal cavity; left in place During insufflation: ______ will connect hosing to the needle ______ will connect hose to the insufflator

Laparoscopic Equipment Fiber optic light cable and light source The cable emits light from the source, through the scope.

Laparoscopic Equipment Camera/video system (optional)

Laparoscopic Equipment Camera/video system

Laparoscopic Equipment Hand instruments These instruments can be passed through cannulas of accessory ports to aid in biopsy retrieval or to perform surgical procedures. *Can grasp, cut, cauterize, staple, or biopsy.

Laparoscopic Equipment Biopsy and grasping hand instrument tips

Laparoscopy Procedure Patient prep: fasting, bladder expressed Clip from _____ process to ______; surgical scrub Recumbency depends on procedure Draping Surgeon will remove scope from sterile packaging Glutaraldehyde or ETCO 2 Sterile sleeve used to cover the camera; scope placed on the head of the camera (camera does not get sterilized) Skin incision made Entry of Veress needle trocar is retracted insufflation tubing can be connected to the needle Second skin incision made Entry of trocar-cannula trocar is removed scope is inserted Any other ports are created

Laparoscopic Procedure

Laparoscopic Procedure

Laparoscopic Procedure https: //www. youtube. com/watch? v=q. Op_G Ar. RWRQ&nohtml 5=False