1. Laparoscopic Instruments & Tower
5th Practical
Department of Surgical Research and Techniques
Laparoscopic Instruments & Tower

2. Department of Surgical Research and Techniques
5th Practical
Department of Surgical Research and Techniques
Requirements:
1. Laparoscopic Tower – Parts and Functions
2. Usage of the Laparoscopic Instruments
3. Practice on the Pelvitrainer

3. Department of Surgical Research and Techniques
5th Practical
Department of Surgical Research and Techniques
Department of Surgical Research and Techniques
Difficulties of laparoscopic technique
Two dimensional approach and three dimensional activity
Eye-hand coordination
Feeling deepth
Coordinate use of dominant and nondominant hand
Lack of tactile sensation
Magnifient surgical territory – finer manipulation
Limitted movement
Unusual instruments

4. Department of Surgical Research and Techniques
Laparoscopic Tower
Diathermy controller (combined mono- and bipolar diathermy)
Monitor
Light source
Camera control unit
Insufflator
Suction-irrigation system
Video recorder
Roller stand
5th Practical
Department of Surgical Research and Techniques

5. Department of Surgical Research and Techniques
Pneumoperitoneum
Department of Surgical Research and Techniques
5th Practical
Lifting the abdominal wall
by insufflation with carbon dioxide gas

6. Department of Surgical Research and Techniques
Veres needle
Connector to insufflation tubing
5th Practical
Department of Surgical Research and Techniques
Sharp outer cannula
Inlet for gas
Spring-loaded inner stylet with a blunt tip
Proper handling position

7. Department of Surgical Research and Techniques
Insufflator
Intraabdominal
pressure (mmHg)
Gas flow
(liter/min)
Amount of the used gas(liter)
Antibacterial filter
Disposable insufflator tubing
5th Practical
Department of Surgical Research and Techniques
Amount of gas in the
gas-cylinder
Power switch

8. Department of Surgical Research and Techniques
Trocars
Outer diameter 2 mm -10 mm
Inner piercing stylus/ Shaft
5th Practical
Department of Surgical Research and Techniques
Valve
Switch
Outer cannula/ Sleeve

9. Department of Surgical Research and Techniques
Safety Trocars
Corkscrew trocar
Sharp and blunt shafts
5th Practical
Department of Surgical Research and Techniques
Spring-loaded plastic shield

10. Department of Surgical Research and Techniques
Trocar Insertion
The first trocar is inserted blindly,
usage of safety trocars is mandatory!
5th Practical
Department of Surgical Research and Techniques

11. Department of Surgical Research and Techniques
Light Source
Degree of brightness
Brightness adjustment
Fibre-optic cable
Power switch
5th Practical
Department of Surgical Research and Techniques
kábel
Check the light cable before use!

12. Department of Surgical Research and Techniques
Telescopes
Traditional
&
Hopkins Telescopes with rod lens
optikai lencsék
quartz rúd-lencse
Length:30 cm
Diameter: 5 mm, 10 mm
Degree: 0°, 30°, 45°
5th Practical
Department of Surgical Research and Techniques

13. Department of Surgical Research and Techniques
Telescopes
5th Practical
Department of Surgical Research and Techniques
Ocular (camera connection)
Light cable connection
Objective lens (0° 30°45°)
Camera
The field of view can be changed by the rotation of the light cable
in 30&40 degree telescopes

14. Department of Surgical Research and Techniques
Camera Controller
Camera
Power switch
Camera plug in
5th Practical
Department of Surgical Research and Techniques

15. Department of Surgical Research and Techniques
Telescope (bajonet) joint
Programing /White balance
Zoom ring
Focus ring
Cabel to the controller
Camera Head
5th Practical
Department of Surgical Research and Techniques

16. Department of Surgical Research and Techniques
Optical System
Light Source
Telescope
Camera
Camera Controller
Video Cable
Video Recorder
Monitor
Surgical Team
5th Practical
Department of Surgical Research and Techniques

17. Department of Surgical Research and Techniques
Diathermy Controller
5th Practical
Department of Surgical Research and Techniques
Double pedal footswitch
Mono- & Bipolar diathermy
Power switch
Bipolar diathermy forceps
Indifferent electrode pad

18. Department of Surgical Research and Techniques
Diathermy
5th Practical
Department of Surgical Research and Techniques
Monopolar
Bipolar
Hook
Forceps head
Insulation + - +

19. Department of Surgical Research and Techniques
Diathermy
5th Practical
Department of Surgical Research and Techniques
Monopolar
Bipolar
Insulated & Non-insulated handles !
Hook
Forceps head
Insulation + - +

20. Department of Surgical Research and Techniques
Suction
(Hgmm)
Irrigation
Sterile saline
Collector bottle for aspirated materials
Suction-Irrigation System
Hand piece/ Shaft
5th Practical
Department of Surgical Research and Techniques

21. Department of Surgical Research and Techniques
Suction-Irrigation System
5th Practical
Department of Surgical Research and Techniques
Tubing
Three-channel tube
Multiple perforation

22. Department of Surgical Research and Techniques
Instruments I.
5th Practical
Department of Surgical Research and Techniques
Dissectors & Grasping forceps
Pistol-grip handle
Parts:
handle
outer tube
working insert
Bowel
Babcock
Allis
Biopsy forceps
Ratchet

23. Department of Surgical Research and Techniques
Instruments II.
5th Practical
Department of Surgical Research and Techniques
Metzenbaum scissors, Hook scissors, Biopsy forceps

24. Department of Surgical Research and Techniques
Unifying Instruments
5th Practical
Department of Surgical Research and Techniques
Clip applier
Staplers

25. Department of Surgical Research and Techniques
Suturing Instruments
5th Practical
Department of Surgical Research and Techniques
Szabó-Berci needle holders
Coaxial handle
Parrot-Jaw needle holder
Flamingo-Jaw assistant needle holder

26. Department of Surgical Research and Techniques
5th Practical
Department of Surgical Research and Techniques
Some pictures of this lecture are presented by
courtesy of Zoltán Szabó Ph.D.