13. Laparoscopic Surgery Flashcards
What are the advantages of laparoscopic surgery over conventional laparotomy?
Laparoscopic surgery offers significant benefits including:
- Less post-operative pain
- Shorter hospital stay
- Faster return to normal activities
- Superior, magnified vision for more precise dissection
- Improved outcomes
What are some of the recent exciting advances in laparoscopic surgery?
Recent advances in laparoscopic surgery include:
- Availability of three-dimensional monitors
- Superior view of the operative field
- Improved safety during the procedure
What is the first step in performing laparoscopic surgery?
The first step is insufflation, where CO2 gas is pumped into the peritoneal cavity using an insufflation needle (Veress) inserted through the umbilicus.
What are the ports used in laparoscopic surgery, and how are they used?
Small cannula-like ports, called trocars, are inserted at various positions into the abdominal wall.
- The ports vary in diameter from 5 to 15mm.
- A 10mm lens with a camera attachment is inserted through one port to project an image onto a screen.
- Three to four additional ports are used for various laparoscopic instruments.
What types of instruments are used in laparoscopic surgery?
The instruments used through the laparoscopic ports include:
Scissors
Forceps
Graspers
Needle holders
Cautery instruments
What instruments are used through the laparoscopic ports during surgery?
The instruments used through the laparoscopic ports include:
- Scissors for cutting tissues
- Forceps for grasping tissues
- Graspers for holding or manipulating tissues
- Needle holders for suturing
- Cautery instruments for cauterizing (burning) tissues to stop bleeding
In which surgical disciplines is laparoscopy used?
Laparoscopy was initially introduced in gynaecology but is now used across all surgical disciplines. It is a standard approach for many procedures, including almost every gynaecological operation.
What is diagnostic laparoscopy used for?
Diagnostic laparoscopy is used to visualize the pelvic organs through two or three small abdominal incisions. It is often performed in women with chronic pelvic pain.
How is laparoscopy used in the diagnosis and treatment of endometriosis?
Laparoscopy is the procedure of choice for diagnosing and treating endometriosis, allowing for superior visualization of the pelvic peritoneum. It involves extensive dissection and excision of diseased areas.
What is the role of laparoscopy in managing ectopic pregnancy?
Laparoscopy is considered the gold standard in managing ectopic pregnancy due to its minimally invasive nature and precision.
How does laparoscopy assist in infertility treatment?
Laparoscopy allows for visualization of pelvic organs to detect abnormalities. A dye test can also be performed to check for tubal patency by injecting methylene blue into the uterus and observing spillage from the Fallopian tubes.
How is pelvic inflammatory disease diagnosed and managed laparoscopically?
Pelvic inflammatory disease can be diagnosed and treated using laparoscopy, allowing for direct visualization and intervention.
What is the laparoscopic approach for tubal ligation?
During laparoscopy, a Filshie clip or a Fallope ring can be applied to block or seal the fallopian tubes for sterilization.
How are ovarian cysts treated laparoscopically?
Ovarian cysts can be drained or excised using laparoscopic instruments.
How is a hysterectomy performed laparoscopically?
In laparoscopic hysterectomy, the upper part of the uterus is dissected with laparoscopic instruments. The uterus is either removed through the vaginal incision or morcellated into smaller pieces and removed through a port. Occasionally, the procedure is completed vaginally in a Laparoscopic Assisted Vaginal Hysterectomy (LAVH).
