Laparoscopy Flashcards
Technique recommended by Monnet, E to minimize the chances of iatrogenic organ damage during the introduction of the Veress needle 
author recommends elevating the abdominal wall with 2 sutures placed on either side of the puncture site when using a Veress needle in young dogs. Stay sutures should be placed in the fascia of the abdominal wall on each side of the puncture site to provide counter traction when the Veress needle or the first cannula is introduced.54-56 Using sharp Veress needles is recommended because they provide better control during the penetration of the needle due to the decreased amount of force required.
Monnet, E. Laparoscopic entry techniques: What is the controversy? Veterinary Surgery. 2019; 48: O6– O14. https://doi.org/10.1111/vsu.13220
Describe the placement on an optical closed-entry clear-tip trocar. Include what the surgeon will observe in the process and whether the cannula valve should be kept open or closed.
The other optical devices have smaller threads and a clear tip that protects the telescope placed in the cannula. When an optical access trocar with a clear tip is used, the different layers that have been penetrated by the cannula with its trocar are clearly visualized.32 Because the
linea alba is mostly a tendon, only 1 white layer of tissue is visible. When the tip reaches the peritoneal space, the tip of
the cannula becomes darker. The different layers of the abdominal wall can be observed during placement of the
cannula. First, the white color of the subcutaneous tissue is
seen, followed by the red color of the muscle layers, and
then the peritoneum with its white color is seen. Finally, when the peritoneum is penetrated, the inside of the peritoneal cavity is dark. If the optical trocar is placed without prior insufflation, it is recommended to raise the abdominal wall with sutures close to the site of introduction while the bladeless clear tro-
car is introduced to minimize the risk of trauma to any abdominal organs.8 If adhesions are present, they will appear
on the clear tip of the trocar. The assembly of the endoscope
in the trocar in the cannula can be directed away from the adhesions to facilitate placement in the peritoneal cavity. It is also recommended to keep the valve of the cannula open while placing an optical trocar. As soon as the peritoneal space is entered, air can gain access to the peritoneal cavity and will allow the abdominal wall to move further away from the abdominal content.
Monnet, E. Laparoscopic entry techniques: What is the controversy? Veterinary Surgery. 2019; 48: O6– O14. https://doi.org/10.1111/vsu.13220
