Composition and Operation Method of Laparoscope

Laparoscope is similar to an electronic gastroscope, it is a medical instrument with a miniature camera. Aparoscopic tools surgery is performed using laparoscopic equipment and related instruments.

Basic components of the laparoscope

Laparoscopic video surveillance system

Laparoscopic video surveillance system includes the laparoscope, light source and pathway, miniature camera, camera converter, monitor (TV), automatic cold light source and recorder. The laparoscope commonly used has a 0 ° and 30 ° viewing angle with various specifications of instruments, including diameters of 10mm, 5mm, and 2.5mm.

CO2 insufflation system

CO2 insufflation system composed of spring insufflation needle (Veness needle), inflation catheter, insufflator and CO2 steel cylinder. The purpose is to provide broad space and vision for the operation. The predetermined intra-abdominal pressure required for surgery is 12-15mmHg and an automatic insufflator.

Irrigation and aspiration system

Irrigation and aspiration system including two parts:

  • Irrigation is used to observe and protect tissue, prevent adhesions, stop bleeding, and repair tissue.

  • Aspiration is performed using a catheter to create a suction effect and sometimes filters are used.

Surgical instrument system

Surgical instrument system for cholecystectomy includes 10mm trocar needle (2), 5mm trocar needle (2), 10mm instrument converter (1), atraumatic graspers (2), curved dissecting forceps (1), insufflation needle, scissors, titanium clips, irrigation-aspiration instrument, electrosurgical separation shovel, and separation hook.

Special instruments for cholangiography include cholangiographic catheter, holding forceps, suture needle, loop ligature instrument, and retrieval net.

Laparoscopic Technique

Artificial Pneumoperitoneum

Make a 1cm incision below the umbilical ring and insert a pneumoperitoneum needle at a 45-degree angle. Once there is no blood, attach a syringe and if the physiological saline goes in smoothly, it means the puncture is successful and the needle is in the abdominal cavity. Connect the CO2 insufflator, and keep the flow rate under 1L/min. The total insufflation volume should be around 2-3L, and the intra-abdominal pressure should not exceed 2.13kPa (16mmHg).

Trocar Cannula

Before inserting the laparoscope, insert the trocar cannula. The incision should be around 1.5cm as the laparoscope is thicker. Lift the lower abdominal wall and insert the trocar cannula slowly into the abdominal cavity first at an angle and then vertically. There may be a breakthrough feeling when it enters the cavity. Remove the trocar core and listen for the sound of the air coming out of the abdominal cavity. Then insert the laparoscope, connect the light source, and adjust the patient's position to a 15-degree head-down tilt while insufflating slowly.

Laparoscopic Observation

The surgeon holds the laparoscope and observes the uterus, ligaments, ovaries, fallopian tubes, and the uterine recess of the rectum. The assistant can move the retractor to change the position of the uterus to facilitate the examination. If necessary, suspicious lesions can be removed and sent for pathological examination.

Removal of Laparoscope

Only after checking for no internal bleeding or organ damage can the laparoscope be removed. After the pneumoperitoneum is evacuated, remove the trocar cannula and suture the abdominal incision covered with sterile gauze and secured with tape.

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