Minimally Invasive Surgery

Question 1

The need for minimally invasive surgery (advantages)

Answer 1

Faster recovery
Shorter hospital stay
Less pain
Cosmetically better
Better Magnification

Question 2

IVITROS

Answer 2

I- insuffolate
V-visualization
I-inspection
T- triangulation
R-retraction of tissue
O-operation
S-seal

Question 3

Best gas for pneumo peritoneum

Answer 3

Co2

Sometimes nitous oxide

Question 4

Pressure for abdominal surgery

Answer 4

10-14 mm hg

Mediastinal surgery-5-8 mm hg

Question 5

Physiological effects of pneumo peritoneum
(Peritoneal streching)

Answer 5

Peritoneal streching

Vagal stimulation

Sinus brady cardia (mc arrythmia)

Pressure on IVC

Venous return is hampered

CO – HR*SV (DECREASE)

compensation by increasing heart rate

Co2 gets absorbed and give rise to metabolic acidosis

Question 6

Pneumo peritoneum diaphragm pushed up

Answer 6

Intra thoracic volume reduces

Intra thoracic pressure increases
(Reduction in TV, TLC, BC, FRC)
In cardiac /COPD we have to be careful

Question 7

What is PEEP?when is it used?

Answer 7

Increasing intra thoracic pressure

Airway resistance

PEEP( Peak end expiratory pressure)

Question 8

Renal effect of pneumo peritoneum

Answer 8

Put pressure on renal artery

Decrease renal blood flow

Decrease GFR

Decrease UO

Activated RAS

Aldosterone

Sodium retention

Question 9

Pneumo peritoneum causes

Answer 9

Peritoneal streching
Diaphragm pushes
Airway resistance
Renal involved
Intracranial tension