Diagnostic Laparoscopy Alexander Parata

Diagnostic Laparoscopy - a procedure that allows a health care provider to look directly at the contents of a patient's abdomen or pelvis, including the fallopian tubes, ovaries, uterus, small bowel, large bowel, appendix, liver, and gallbladder.

Basic Equipment Camera/Laparoscope Video Monitor Insufflator Light source ESU Stirrups

Basic Instruments Laparotomy set Laparoscopy set Vaginal Tray  Auvard Weighted Speculum  Sims Uterine sound  Cervical dilators  Tenaculum forceps

Pre Op

Anesthesia : General/local Position: lithotomy Prep: Laparotomy + Vaginal Prep Draping: Laparotomy + Lithotomy drapes ▫1x urethral catheterization done prior to prep

Basic Laparoscopy Procedures

1. Handheld vaginal retractor (Auvard Weighted Speculum) placed posteriorly in the vagina and the cervix is grasped with a tenaculum. 2. Uterine manipulator is placed into cervix. 3.Anterior abdominal wall is elevated (use 2 towel clips)

4. Midline incision is made with #11 blade. 5. Veress Needle in inserted to fascia in order to enter the abdominal cavity. 6. abdominal cavity is inflated with 3 liters of CO 2 (pressure mmHg)

7. Remove veress Needle and extend the incision to 1 cm (length). To insert Laparoscopic trocar+Sleeve into the abdominal cavity. 8. The trocar is removed from the sleeve and is replaced with at laparoscope. - co2 line connected to valve on sleeve -laparoscope connected w/ light source, camera, monitor.

9. After operative intervention the CO 2 is released and all ports are removed. 10. Close incision (suture/steri strips)

Post Op

PACU Return to normal activities Possible COMPLICATIONS: -Hemorrhage -Wound infection -Perforation of viscus