endoscopes

Question 1

Laparoscopic Access & Dissection
Devices

Answer 1

• A dissecting balloon that separates tissue forming a cavity for laparoscopic in hernias they can be oval or round

Question 2

Camera

Answer 2

• Viewing
• Pass the plug end of the camera
  off the sterile field to be plugged
  into a camera box.
• Projects images of an enclosed
  space when the camera head is
  connected to the eyepiece of an
  endoscope with a light cord
  attached.

Question 3

Light Cord

Answer 3

• Accessory
• Tight bundle of fiber optic strands
  of glass that transmits light into
  an enclosed space when
  connected to an endoscope.
• Reduction of light conduction can
  results from broken fiber optics
  from being coiled too tightly or
  anything is allowed to crush it.

Question 4

Laparoscope

Answer 4

• Viewing
  Size: Variable (5-10 mm) diameter, lens variable degrees
• Endoscope placed through a trocar sleeve into the abdomen to view organs/tissues.
• The outer edge of the scope is surrounded by light fibers that pass through the light cord and illuminate the abdomen. These fibers can be damaged if special care is not used with this scope. (can be one of the most expensive repairs.

Question 5

Veress Needle

Answer 5

Supply

Size: variable (regular or long)

• Introduces CO2 gas into the abdomen to distend the abdominal cavity allowing visibility by pushing the abdominal wall away from the organs during laparoscopic procedures. (pneumoperitoneum)
• it is put in at the initial incision then inflates to 12-15mmhg then removed.

Question 6

Insuflation Tubing

Answer 6

Supply

• This tubing is attached to a
  CO2 gas pump then connected to veries needle and remove sleeve ( kept throughout the procedure.
• The tubing has an inline filter
  to reduce contaminants that
  may enter the surgical site.
  This filter end should be
  passed off to the circulator

Question 7

Trocar with Sleeve

Answer 7

Supply/Retracting/Viewing/Cutting

Size: Variable (5, 10 and 12 mm)
DIFF styles etc blade, non blade, etccc

Sleeve provides a leak free seal (retains CO2 gas when instruments are placed/removed) that protects the skin and tissue layers from
damage sustained while manipulating or introducing instrumentation.

Trocar: Used to dissect through abdominal tissue (after small skin incision is made) to provide access to the abdominal cavity during endoscopic procedures

Question 8

Trocar Anchoring System

Answer 8

Supply

Sutures are placed on both sides of the sleeve and wrapped around the anchor to seal it against the abdominal wall and then insufflation is introduced.

• Used in open technique when a blunt trocar with an anchor is inserted without the prior use of pneumoperitoneum through a small incision in the fascia layer.

Question 9

SILS port

Answer 9

• Supply
• A flexible laparoscopic port that can accommodate up to three
  instruments through a single incision

Question 10

Reducer cap

Answer 10

• Supply
• This devise clips on the top of a 12 mm or 10 mm trocar sleeve allowing 5 mm instruments to be used in larger ports without loosing pressure in the pneumoperitoneum.

Question 11

Micro Scissors

Answer 11

Cutting/Dissecting

• Used to make very small cuts in fine structures such as the cystic duct

Question 12

Hook Scissors

Answer 12

• Cutting/Dissecting
• Hooked tip helps to keep slippery structures (such as ducts and vessels) within the jaws of the scissors while the cut is made.

Question 13

Endoshear Scissor

Answer 13

• Cutting/Dissecting

Size: Variable (5mm or 10mm)

• Most frequently used very sharp dissecting scissor. Used similarly as a metzenbaum scissors in an open case.

Question 14

Endo Grasper

Answer 14

• Grasping/Holding
• Atraumatic: Has a wide jaw to grasp and manipulate larger amounts of tissue.

Question 15

Bullet Tipped Grasper

Answer 15

• Grasping/Holding
• Atraumatic: common grasper used on most tissue types.
• It is named for its tip which is shaped like a bullet.

Question 16

Maryland Dissector

Answer 16

• Grasping/Holding/Dissecting
• Atraumatic: Used similarly as a debakey would be in an open case.
• The fine curved tip is used for blunt dissection of fatty or thin tissue (omentum, mesentery, connective tissue).

Question 17

Aggressive Toothed Grasper

Answer 17

• Grasping/Holding

Size: Variable (5mm or 10mm)

• Traumatic: used to hold tissue that will be removed. Be sure the surgeon is aware the grasper has teeth when it is handed to him
• Commonly used to remove the slippery gallbladder

Question 18

Endoscopic Allis Clamp

Answer 18

• Grasping/Holding
• Traumatic: Used to firmly hold moderate
  strength tissue or tissue that is being
  removed.

Question 19

Endoscopic Babcock

Answer 19

• Grasping/Holding
• Atraumatic: Used for grasping fragile tissues
• Just like the conventional babcock clamp, it grasps bowel, appendix, stomach, and fallopian tubes safely.

Question 20

Olson Clamp

Answer 20

Grasping/Holding

• Atraumatic: Used during a Laparoscopic Cholecystectomy in conjunction with a Taut catheter and radiographic dye in a syringe
• The Taut catheter is loaded into the lumen of the handle of the clamp, and then the syringe
  of dye is connected to the catheter. The cystic duct is clamped closed with a staple proximal
  to the gallbladder. Next a tiny nick is made below the staple and the Taut catheter is
  introduced into the duct and advanced a short distance. The jaws of the Olson clamp are
  then locked shut, compressing the duct. Next the surgeon injects radiographic dye into the
  duct. Any stones blocking the duct will appear in x-ray, telling the surgeon if further
  exploration will be required.

Question 21

Endoscopic biopsy punch

Answer 21

• Cutting
• Traumatic: Used to remove a bite of tissue to
  be sent as a specimen to pathology.

Question 22

Blunt Probe

Answer 22

• Retracting/Viewing/Probing
• Atraumatic: Used to manipulate tissue while
  exploring the abdomen and pelvis

Question 23

Needle Aspirator

Answer 23

• Suctioning
• Traumatic: This devise is used to collapse fluid filled cysts or possibly the gallbladder. The leur lock end of this tube is attached to suction or a large syringe. The needle end is then used to puncture the sack and the liquid contents are evacuated.

Question 24

Suction Bovie

Answer 24

• Suctioning/Occluding
• This instrument will be attached to suction at its leur lock end and to an electrical cord at the metal prong. It is then plugged into a bovie machine and operated by the surgeon
  using a foot pedal. This allows the surgeon to evacuate bovie smoke from the field as it is produced.

Question 25

Hook Bovie

Answer 25

• Occluding/Cutting

Comes in L hook and J hook varieties.

• This bovie has a hook on the end to allow the surgeon to hook around tissue and cut through it using electrical current. This current is activated by pressing on a foot
  pedal when needed.

Question 26

Endo Catch

Answer 26

Supply

• Single use specimen pouch used to retrieve a specimen and remove it through a 10-12mm sleeve while containing contents securely during retrieval process.
• Once contents are placed into the pouch the ring on the end is pulled. This “purse strings” the pouch closed.

Question 27

Laparoscopic Fan Retractor

Answer 27

• Retracting/viewing
• Atraumatic: Used to bluntly retract the liver or other broad organs.
• The dial at the bottom widens the fingers to create the broad fan.

Question 28

Endoscopic Kitner/Peanut/Cherry

Answer 28

• Supply
• Blunt (intentional tearing of tissue)
  laparoscopic dissection in small areas.

Question 29

Anti-Fog

Answer 29

supply

Anti-fog should be allowed to completely dry on the tip of the scope for full effectiveness (don’t wipe it off with a sponge after application).

• Used on the tip of scopes to prevent fogging when a cold scope is placed
  in a warm body

Question 30

Scope Warmer

Answer 30

• Supply
• Used to warm the tips of scopes to prevent fogging when a cold scope is placed in a warm body
• Heat activation varies per device