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Intro to Surgery > Lecture 23 - Minimally Invasive Surgery > Flashcards

Lecture 23 - Minimally Invasive Surgery Flashcards

1
Q

Minimally invasive surgery _____ damage to tissues.

A

reduces

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2
Q

Minimally invasive surgery is performed via _____ incisions; is not “_____”.

A

smaller, open

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3
Q

Minimally invasive surgery usually involves a _____. What is the suffix for a procedure like this?

A

camera, -oscopy

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4
Q

Endoscopy was started by who? What did this person do?

A

Philipp Bozzini;

Developed a light conductor called the Lichtleiter and directed light into the internal cavities of the body

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5
Q

What are 5 advantages to MIS?

A
  1. Less blood loss (can visualize better)
  2. Less scarring and less damage to body
  3. Shorter hospital stays
  4. Decreased pain
  5. Earlier resumption of normal activities
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6
Q

What are 3 main disadvantages of MIS?

A
  1. Operations may last longer (greater learning curve for surgeon and requires advanced training)
  2. Operations may cost more (equipment is costly)
  3. May be more difficult for the surgeon
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7
Q

What are 7 other disadvantages to MIS?

A
  1. $$$
  2. Effects of pneumoperitoneum or pneumothorax
  3. Trocar insertion
  4. Ergonomics
  5. Pressure ischemia during long procedures
  6. Gas emboli
  7. Equipment failure
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8
Q

What are some common procedures done by MIS?

A

Laparoscopy, arthroscopy, endoscopy, cystoscopy, hysteroscopy, biopsies, orthopedic procedures

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9
Q

What types of procedures would use a flexible camera?

A

Colonoscopy, laryngoscopy, bronchoscopy, sinoscopy

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10
Q

What types of procedures would use a rigid camera?

A

Laparoscopy, arthroscopy, thoracoscopy, sinoscopy

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11
Q

How does the camera light source connect to the scope?

A

Through fiberoptic cable

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12
Q

What light source is preferred for a camera?

A

Xenon light source

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13
Q

What is the advantage to having a videocamera?

A

Allows magnification of the view

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14
Q

Why do we perform arthroscopy?

A

Visualize the joint, magnification and fluid medium

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15
Q

Arthroscopy is routine treatment for joint diseases in _____ and _____.

A

dogs, horses

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16
Q

What are 4 benefits to using arthroscopy vs. arthrotomy?

A
  1. Less isruption of periarticular tissue
  2. Earlier return to normal function
  3. Can operate multiple joints at a time
  4. Better cosmetic outcome
17
Q

What is the most common size scope used in horses?

A

4.0 mm

18
Q

What is the most common size scope used in dogs?

A

2.7 mm

19
Q

What angle is favored by arthroscopists?

A

20-30 degrees

20
Q

What are cannulas used for?

A

Allow the arthroscope to be inserted into the joint, protects it from bending or breaking

21
Q

What instruments are used for arthroscopy?

A

Probe, curettes, grasping forceps

22
Q

Why do we use fluids during arthroscopy?

A

Pressure controls hemorrhage

Flattens synovial membrane and distends joints to provide greater visualization

Removes debris

23
Q

Why do we induce a pneumoperitoneum and what gases can be used?

A

Distends area so you can see;

CO2, air, oxygen, N2O, argon, helium, mixtures

24
Q

Why is CO2 the best choice for insufflation?

A
  1. High diffusion coefficient
  2. Normal metabolic end product
  3. Rapidly cleared
  4. Highly soluble in blood and tissues
  5. Does not support combustion
  6. Risk of gas embolism low
25
Q

What gas is preferred in patients with cardiac disease and why?

A

N2O due to possible induced hypercarbia with CO2

26
Q

What pressure is safe for pneumoperitoneum?

A

15 mm Hg or less

27
Q

What diameter vessel can Ligasure be used on?

A

7mm or less

28
Q

What procedures can be done laparoscopically?

A

Biopsy, hernia repair, closure of nephrosplenic space/epiploic foramen, cryptorchid neuter, ovariectomy, gastropexy, abomasopexy

29
Q

What instruments can be inserted into an endoscope through the biopsy channel?

A

Biopsy forceps, baskets for FB retrieval, laser for tissue resection and cautery

30
Q

What orthopedic procedure can be done with MIS?

A

Fracture repair

31
Q

What is a da Vinci system?

A

Surgical robot with 3-4 arms that are inserted through incisions;

One arm is a camera and 2 act as the surgeon’s hands

Optional 4th arm moves things out of the way

32
Q

What is an advantage to using a da Vinci rather than doing the surgery manually?

A

Robot can make tiny, precise movements - eliminates microtremors from human hands

33
Q

What are disadvantages to robotic surgery?

A

Training, time, cost of unit, cost to patient, size

Intro to Surgery (36 decks)

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