Endoscopic and MIS

Question 1

Definition of laparoscopy

Answer 1

Examination of the abdominal cavity or performance of minor abdominal surgery using a laparoscope

Question 2

Definition of endoscopy

Answer 2

Examination by means of an endoscope

Question 3

Endoscopes can be

Answer 3

Flexible, rigid or semi-rigid

Question 4

Examples of flexible endoscopes

Answer 4

Angioscopes, bronchoscopes, choledochoscopes, colonoscopes, hysteroscopes, utereroscopes

Question 5

Potential complications to laparoscopic surgery

Answer 5

Hypoxemia

Hypercarbia

Cardiac dysrhythmia

CO2 embolism

Question 6

Components of an imaging chain (Tower)

Answer 6

Video monitor (s)

Camera and camera control unit

Fiberoptic light cable

Video cables

Light source

Any peripheral devices required for recording/documentation

Question 7

Three principle types of light sources are used in endoscopy:

Answer 7

Light emitting Diode (LED): Immediate full light intensity, long life- energy efficient, environmental friendly

Metal halide: emits a continuous blue light, not as bright as LED or Xenon sources

Xenon: Emits a pulsing, high-intensity white light

Question 8

Other equipment that may be set up along with the tower

Answer 8

CO2 insufflator

ESU

Laser

Smoke evacuator

Suction/irrigator

Fluid management

Question 9

Insufflation flow rate and pressure should start at

Answer 9

1L per minute otherwise gas embolisms can occur when large amounts of CO2 directly enter a blood vessel

Question 10

Gases commonly used for insufflation

Answer 10

Carbon dioxide

Nitrous oxide

Helium

Question 11

Maintaining an intra-abdominal pressure of less than ___ in adult patients ___

Answer 11

15mmHg reduces the risk of systemic hemodynamic changes

Question 12

CO2 is gas of choice because it is

Answer 12

Inexpensive

Readily absorbed by the body without serious adverse effects

Rapidly eliminated

Suppresses combustion

Question 13

Fluid management in MIS is critical both for ____. The risks involved are ____ ____.

Answer 13

Irrigation and distension fluids

Risks involved are hypothermia and fluid overload

Question 14

Zone I MRI safety zone is:

Answer 14

uncontrolled and can be accessed by the public or if in the surgical suite, can be accessed by all personnel.

Question 15

MRI Safety Zone II is the

Answer 15

interface between zones I and III

Question 16

MRI Safety zone III is:

Answer 16

Strictly controlled and contains the control room or vestibule for screened patients and personnel

Question 17

MRI Safety Zone IV is:

Answer 17

Scanner room and can only be entered by SCREENED PERSONNEL and PATIENTS bc of the strong magnetic force in this zone. Only MRI compatible equipment may be used during procedures involving MRI

Question 18

Complications to monitor for after MIS

Answer 18

Venous stasis and subsequent DVT and pulmonary embolism

Potential pressure injuries as a result of positioning or inadvertent external pressure from the surgical team members or equipment leaning on the patient

Complications resulting from the resulting from the creation of the pneumoperitoneum (CO2 embolism, hypercarbia, tension pneumothorax)

Hypothermia resulting from use of ambient temperature irrigation of distention fluids

Fluid overload

Question 19

Assessments needed to be made before an endoscopic surgery

Answer 19

History of deep vein thrombosis

Consent for open surgery

History of previous incisions

Question 20

MIS brings risks to patients such as

Answer 20

Light sources (can cause fires)

Trocar injuries to internal organs

Co2 insufflation injuries

Potential for retained bioburden (possible SSI)

Possible electrical injury

Question 21

Rigid endoscope examples

Answer 21

Angled, straight or direct visualization

High resolution

Cystoscopes, bronchoscopes, arthroscopes, nasal endoscopes, laryngoscopes, laparoscopes

Question 22

Laparoscopy requires

Answer 22

establishing a pneumoperitoneum (insufflation of CO2 in abdominal cavity)