1. Laparoscopy To examine peritoneal cavity and its viscera
A type of endoscope, called a laparoscope, is placed through a small ______________ in the skin of the ventral abdomen
*What was the other type of
endoscopy that requires an
incision?

2. Laparoscopy: Advantages
Smaller incisions
Decreased hospitalization time
Lower post operative infection rate
Decreased post-op pain

3. Laparoscopy: Contraindications

4. Laparoscopy Equipment
Veress insufflation needle
Gas insufflator and hose
Trocar
Cannula
Laparoscope
Fiber-optic light cable
Light source
Camera/video system (optional)

5. Laparoscopic Equipment
Veress insufflation needle
Used during insufflation of the peritoneal cavity
Needle pierces through abdominal layers, into peritoneal cavity; left in place
During insufflation set-up:
_________ person will connect hose to the veress needle
____________ person will connect other end of hose to the gas insufflator

6. Gas Insufflator
Tubing is connected from the gas insufflator to the Veress needle.

7. Laparoscopic Equipment
Gas insufflator
Machine that allows a gas to continuously expand the abdominal cavity
Required for better visualization of the viscera
Other parts needed: insufflation needle, sterile hose, and gas cylinder
______________ – the recommended gas due to rapid absorption
Flow rate of __________________
Nitrous oxide and room air are also options (not common)
Must monitor intra-abdominal pressure!
Not to exceed ______________

8. Laparoscopic Equipment
Trocar–cannula units
Sharp trocar (inside of the cannula) punches through the abdominal wall
Sharp trocar can be replaced with a blunt trocar
or the laparoscope
Cannula is left in place

9. Laparoscopic Equipment
Laparoscope
_________, metal tube with a light port
Can also have an instrument port
Come in various lengths and diameters
Cannot be autoclaved! Use: ____________________

10. Laparoscopic Equipment
Fiber optic light cable and light source
The cable emits light from the source, through the scope.

11. Laparoscopic Equipment
Camera/video system (optional)

12. Laparoscopic Equipment
Camera/video system

13. Laparoscopic Equipment
Hand instruments
These instruments can be
passed through cannulas of accessory ports to aid in biopsy retrieval or to
perform surgical procedures.
*Can grasp, cut, cauterize, staple, or biopsy.

14. Laparoscopic Equipment
Biopsy and grasping hand instrument tips

15. Laparoscopy Procedure
Patient prep: fasting, bladder expressed
Clip from _________ process to ___________; surgical scrub
Recumbency depends on procedure
Draping
Surgeon will remove scope from sterile packaging
Sterile sleeve is used to cover the camera; scope placed on the head of the camera (camera does not get sterilized)
Skin incision made
Entry of Veress needle  trocar is ___________  insufflation tubing can be connected to the needle
Second skin incision made
Entry of trocar-cannula  trocar is _______________  scope is inserted
Any other ports are created

16. Laparoscopic Procedure

17. Laparoscopic Procedure

18. Laparoscopic Procedure