Laparoscopic abdominal surgery and Open abdominal surgery (incl. laparotomy) Flashcards
1
Q
What are some complications of laparoscopy?
A
Acute:
- general risks of anaesthetic
- vasovagal reaction (e.g. bradycardia) in response to abdominal distension
- extra-peritoneal gas insufflation: surgical emphysema
- injury to gastro-intestinal tract
- injury to blood vessels e.g. common iliacs, deep inferior epigastric artery
Medium-term:
- Shoulder tip pain - due to diaphragm irritation by air
2
Q
What are the benefits of laparoscopy?
A
- Less pain following the procedure.
- Lower risk of complications.
- A shorter hospital stay and a quicker recovery.
- A much smaller scar.
3
Q
Define laparoscopy.
A
Intraabdominal surgical procedure where laparoscopes (thin telescopes) are used to magnify structures in abdomen. Inserted through small incisions.
4
Q
What are some indications for diagnostic laparoscopy?
A
Suspected:
Endometriosis
PID
Ectopic pregnancy
Ovarian cyst
Appendicitis
5
Q
What are some indications for laparoscopic surgery?
A
- Cholecystectomy
- Appendicectomy
- Endometriosis ablation
- Small bowel resection
- Sterilisation
- Oophrectomy
- Biopsy
6
Q
How is laparoscopy done?
A
- General anaesthesia
- 1-2cm cuts
- Camera cut below the umbilicus, and 2 or 3 other cuts (although single-port laparoscopies are done now)
- Carbon dioxide used to inflate abdomen for better visualisation
- Once finished incisions are sutured and dressings applied
7
Q
What does this scar indicate?
A
Midline laparotomy
8
Q
Label these incisions.
A
- Kocher’s - for open cholecystectomy
- Right para-median laparotomy
- Midline laparotomy
- Nephrectomy
- McBurney’s/Gridiron - appendicectomy
- Laparoscopy - can be used for lapchole/ appendicectomy/ gynae surgeyr
- Left para-median - anterior rectal resection
- Pfannenstiel (transverse suprapubic) - C-section, total abdominal hysterectomy
- Inguinal hernia (either side) - hernia repair
Right angle to no. 5 would be Lanz for appendicectomy.
