Laparoscopy Flashcards
What is Laparoscopy?
Laparoscopy is a minimally invasive surgery (key hole surgery) to look into the abdomen.
- It is done with a laparoscope (a thin, lighted tube).
- It is a type of endoscope but with a tiny video camera.
What are the advantages of Laparoscopy?
1) Rapid return to function (can be done standing)
2) Relatively non-invasive
3) Quick to perform
What are the disadvantages of Laparoscopy ?
1) expensive equipment
2) Requires a skilled surgeon (assistant)
3) video image is two dimensional
4) discomfort post-op due to insufflator (carbon dioxide)
What orientation must the the horse be in during a Laparoscopy?
1) Standing
2) Recumbent under general anaesthesia
What are the indications for Laparoscopy in the Equine patient
1) Chronic Weight loss
2) Colic (chronic/Acute)
3) intraabdominal haemorrhage
4) Peritonitis
5) Neoplasia
6) Adhesiolysis
7) Vaginal-uterine tears
8) rectal tears
9) Rectal prolapses
10) Mesocolic ruptures
11) Gastric ruptures
12) abdominal abscesses
13) Uterine artery ruptures
14) Cryptorchidectomy
15) ovariectomy
16) granulosa cell Ovariectomy
17) colopexy
18) cystorraphy
19) cystotomy
20) inguinal herniorrhapy
21) removal of infected umbilical remnants (RUMINENTS)
22) BIOPSY
BAsically anything thing abdominal
What is the most frequent indication for Laparoscopy in the HORSE
Cryptorchidectomy
What equipment is used during a Laparoscopy?
1) Laparoscope
2) Insufflator (carbon dioxide)
3) Long handle instruments
4) light source
5) monitor
What insufflator is used in laparoscopy and how is it different to arthroscopy?
laparoscopy–> Carbon dioxide, requires a huge volume (>10L/min), 10-15mm Hg
Arthroscopy–> fluid
What is a Verres Needle and What is it used for?
-used for belly taps
has a spring loaded obturator, which is cannulated so you can collected fluid samples without perforating gutt, it can be used to distend the abdomen too.
What type of light source is required for Laparoscopy?
-requires a good light sources (Xenon 300 watts)
What diameter and angle is required for a laparoscope?
Laparoscope–>10mm, 30 degree, 50cm long
Arthroscope–>4mm, 25730 degree
What are the landmarks for Standing Laparoscopy?
1) 18th rib
2) internal abdominal oblique muscle
(half way between the dorsal and abdominal oblique muslce)
3) tuber coxae
What is required for recumbent Laparoscopy?
1) use IPPV
2) tilt table at 30 degree angle (allows abdominal organs to move cranially, good for work in the caudal abdominal region)
What type of ligature is placed internally during a laparoscopy?
Roeder Knot
requires:
- introducers sleeve
- pushrod
- and ligature
What is the downfall for PDS clips in Horses
to small!!!!
they are great for small animals use but they are not really used in Large animal
What are some post operative complications of Laparoscopy?
1) post op discomfort (carbon dioxide+ abdominal fluid –> carbonic acid= irritating to the peritoneal lining)
- can be fixed with banamine
2) Haemorrhage (caution with the caudal epigastric artery and vien)
3) local incision infection
What type of local block is used for laparoscopy?
inverted L block with lidocaine
Which is easier to perform Laparoscopy or Thoracoscopy and why?
Thoracoscopy:
Structures in the thorax are anchored tightly and require less retraction
Why do thermal injuries occur from electrosurgery during minimally invasive procedures?
A portion of the activated instruments used to deliver the electrical current may be beyond the viewing range
To avoid cardiovascular compromise, gas in the THORAX should be maintained below_____?
8-10mmhg
To avoid overinflation, intraabdominal pressure should be maintained at how many meg?
10-15mmhg
What effects does laparoscopy have on the cardiopulmonary function of an anesthetize patient?
1) decrease tidal volume
2) increase intrapulmonary shunting
3) increase dead space
