LP 1-4 Flashcards
diagnostic scope
observation only
pennington clamp
grasp hemorrhoid
draping for hysterectomy
UBD
diagonal towels
litho/gyne sheet and leggings
heaney retractor
hold open side walls on hysterectomy
endocatch
enclose specimen
heaney clamp
clamp uterine ligaments and vessels
what should you provide to establish infra umbilical incision for lap procedure?
scalpel, forceps, electrocautery
ferguson moon rectal speculum/retractor
retract rectal tissue
reasons for gallbladder removal
cholecystitis
gallstones
cancer
skin hooks
retract skin edges
deep group
internal transverse abdominis muscle
what may the surgeon use to reinforce the floor of the inguinal canal?
mesh
hypaque
dye used during an operative cholangiogram
what structure passing through the inguinal canal must be protected when an inguinal hernia repair is performed for a female?
round ligament
pratt rectal speculum/retractor
retract rectal tissue
what should be done once the laparoscope is inserted?
examine the peritoneal cavity
why are legs lowered in a slow smooth movement?
to prevent severe hypotension
what is a verres needle used for?
establishment of orifice into abdominal for endoscopic entry
hegar dilators
dilate the cervix
rectocele
protrusion of the anterior rectal wall into the vagina
alligator forceps
grasp ear tubes
anesthesia for abdominal laparoscopy and why?
general, carbon dioxide irritates diaphragm so they need to be ventalated
reducible hernia
contents of sac can be returned to the normal intra abd position by manual manipulation
what is a vaginal hysterectomy?
removal of the uterus through an incision into the vaginal wall and pelvic cavity
endoscopic ligaclip appliers
occlude vessels or tubular structures
foerster ring forceps
hemostasis and visualization
how should a fiber optic ligh cord be handled?
don’t put on drapes, don’t kink
position for hernia surgery
supine
endoscopic suction/irrigator system
rinse surgical area and check for bleeding
jacobs chuck
attachment for drill bits
senns retractor
retract skin edges
factors that contribute to a direct inguinal hernia?
poor nutrition, age, COPD
oscillatting blade
cut/saw bone
verres needle
insufflation of abdomen
fiberoptic light cord
transports light to scope
umbilical hernia
abdominal wall defect occurring in the linea alba at the umbilical ring
what is attached to a telescope?
camera and fiberoptic light cord
fred
defog lens of laparoscope
largest internal organ in body
liver
arthroscopy pump
irrigation when scoping joints
what rubbed on telescope to prevent fogging?
FRED
endoprobe
move organs as needed
stevens tenotomy scissors
fine dissection
osteotomes
shave/cut bone
russian tissue forceps
grasp dense tissue
trocar
used to create working ports
what type of tissue is a hernia sac?
peritoneum
what is a hysterectomy contraindicated for?
large uterine tumor
pelvic malignancy
weitlander retractor
retracting
avuard vaginal speculum
posterior vaginal wall retraction
strangulated hernia
compromised or absent blood supply
plastic metz scissors
plastic procedures
endoscopic fan retractor
retract organs during a laparoscopic procedure
what happens after the cystic arty and duct are double clipped and divided?
gallbladder is removed from the hepatic bed
why would a vaginal hysterectomy be done?
benign disease or carcinoma of cervix, uterine prolapse
what gas is utilized for pneumoperitoneum?
carbon dioxide, readily available
disadvantages of MIS
longer operative time, more expensive
babcock forceps
grip
why is bladder drained for hysterectomy?
visualization and protect bladder from being knicked
operative scope
channeled for irrigating, suctioning
mallet
drive osteotomes
double action ronguer
bite off tissue
what is caused by weakening of the abdominal wall?
inguinal, femoral, incisional
why are SCD’s used for vaginal hysterectomy?
hemodynamic changes can occur with the lithomy position
taut cholangiocath
inject dye into cystic duct
cystic artery is exposed and ligated with what?
3 clips (1 proximal and 2 distal to the gallbladder)
graves vaginal speculum
retract vaginal walls anterior and posterior
incision for laparoscopic procedure
infra umbilical
insufflator
used to expose area by insufflation with CO2 gas
endoscopic cautery cord
connect cautery to ESu
endoscopic l hook cautery
coagulation and dissection
electrocautery for lap chole
remove the gallbladder from the liver
necrosis of a portion of the intestine results in what type of hernia?
strangulated
what may be punctured when introducing trocar blindly?
sm intestins, bladder
used to retract the spermatic cord in the male
penrose drain
single action ronguer
bite off tissue
insufflator tubing
deliver co2 gas to insufflate abdomen
heaney needle holder
suture after ligation of uterine ligaments, hysterectomy
freer periosteal elevator
free soft tissue
specimen with surgeon
ask if its okay to hand off
where is light source located?
tower and off sterile field
what is a hernia?
protusion of normal abd contents
what can cystocele cause?
urinary incontinence
what happens is abdominal pressure exceeds safe limits what may be the complications?
increase risk of pulmonary and circulatory complications
endoscope
lighted telescopic instrument
iris scissors
delicate dissection
o sullivan o conner retractor
hold open abdominal incisions
trocar/sheath
pass laparoscope and instrumentation into pelvic
femoral ring
slightly lower than inguinal ring
ballentine clamp
clamp uterine ligaments and vessels
surgical prep for hysterectomy
umbilicus to mid thigh, groin and perineal area
telescope
used to acquire image of abdominal cavity
what is the hook scissors used for?
divide the cystic duct and artery
instrument needed after cystic duct is exposed
clip applier
briesky vaginal retractor
retract vaginal side walls
what should you provide after the surgeon separates the spermatic cord?
dissecting scissors, penrose drain, forceps
what is the CO2 hooked to?
verres needle or trocar/cannula
what assists with trocar and cannula in cholecystectomy?
laparoscope
saw with reciprocating blade
saw/remove bone
complications associated with endoscopic procedures
gas embolism
circulatory problems
key instrument used to expose cystic duct and artery
maryland dissector
camera and cord
transmits image to monitor
endoscopic maryland dissector
dissection of fine tissue
where is the cervix located?
lower narrow end of uterus
how does the pt end up for lap chole?
reverse trendelenburg
cholangiogram set up
used to inject radiopaque dye when doing a cholangiogram
hurd dissector
dissection blade
safe intra abdominal pressure
14-16mm
what instrument is used to clamp the ligaments for hysterectomy?
heaney clamp
where is the gallbladder located?
RUQ
anoscope
dilate anal canal
direct hernia
through area of muscle weakness in the abdomen, is acquired
incision for inguinal hernia
oblique
MIS
eliminates the need to cut through tissue/muscle
endoscopic procedures
hysteroscopy
cystoscopy
knee arthroscopy
probe/groove director
following sinus or fistula tract
key
used to tighten chuck attachments
cystocele
bulging of the anterior vaginal wall beneath the floor of the bladder
incisional hernia
occurs along the incision of a previous abdominal surgery
endoscopic mets scissors
cut/ligate structures
disposable instruments at end of surgery
need to be counted if the laparoscopy was successful
where is the uterus located?
between the rectum and bladder
ENT bovie/suction
remove adenoids
pneumoperitoneum
presence of gas/air in the peritoneal cavity
what should be passed after dissection of the gallbladder?
endoscopic alligator or claw forceps
regnell/finger retractor
retract
disadvantage of lap chole?
trauma to the liver when it is dissected from the gallbladder
camera
visualization of anatomy, takes pictures
anterior/posterior repair
posterior repair follows anterior
why do legs need to padded with stirrups?
prevent saphenous nerve and vessel damage
endoscopic grasping forceps
hold or stabilize organs
wire driver
inserting pins, wires into bones
bone currette
shape and scrape bone
why is a glove used with a weighted speculum?
contain blood
when should bowel instruments be variable for hernia surgery?
strangulated
burrs
remove uneven or unwanted bones
why is the verres needle injected with a syringe filled with saline?
to make sure you aren’t in any organs
4 advantages of laparoscopic/endoscopic surgery
short hospital stay
decrease post op pain
less tissue damage
shorter recovery time
ferris smith tissue forceps
grasp heavy tissue
what structure passing through the inguinal canal must be protected when an inguinal hernia repair is performed for a male?
spermatic cord
who is positioned on the patients left side during lap chole?
main surgeon
robinson red rubber catheter
drain bladder
nibbler
bite off tissue
what can cause a direct inguinal hernia?
chronic cough, ascites, straining to void
cystic duct
tubular canal that carries bile from gallbladder to common bile duct
superficial group
external and internal oblique muscles
bone rasp
used to smooth rough edges
indirect hernia
viscera slides into inguinal canal at the deep inguinal ring
ear tubes
allow equalization of pressure in ear
Jacobs vulsellum forceps
grasp cervix
single tooth tenaculum
grasp and manipulate tissue
major supporting structure of the inguinal floor
transversalis fascia
reciprocating blade
cut/saw bone
ligaments for a vaginal hysterectomy and in order
uterosacral, cardinal, broad, round
incarcerated hernia
herniated tissue that is trapped outside its normal location, tissue is still viable
endoscopic spatula cautery
thermal coagulation of bleeders
laparoscope
viewing of the abdominal organs
endoscopic hook scissors
divide cystic artery and duct
why is a cystocele repaired before a rectocele?
contamination
irreducible hernia
contents of sac are trapped in an extra abd sac, and can’t be manually reduced
endoscopic claw grasping forceps
penetrating hold and extraction of tissue
puncture sites for lap chole
subxiphoid area and 2 in the right subcostal area
layers of the uterus
outer peritoneal
myometrium
endometrium
common laparoscopic surgeries
hernia repair, bowel resection
