A laparoscopy is a surgical procedure that examines the organs inside the abdomen, as well as other closed spaces, such as the knees. It’s a low risk, minimally invasive procedure that requires only small incisions.
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When an abdominal laparoscopy is performed, a doctor uses an instrument called a laparoscope to look at the abdominal organs. A laparoscope is a long, thin tube with a high intensity light and a high resolution camera at the front. The instrument is inserted through an incision in the abdominal wall. As it moves along, the camera sends images to a video monitor.
A laparoscopy, also known as a diagnostic laparoscopy, allows your doctor to see inside your body in real time, without having to make large incisions. Your doctor can also obtain biopsy samples during this procedure, as well as also perform surgery.
A laparoscopy is often used to identify and diagnose the source of pelvic or abdominal pain. It’s usually performed when noninvasive methods are unable to help with diagnosis.
In many cases, abdominal problems can also be diagnosed with imaging techniques such as:
A laparoscopy is performed when these tests don’t provide enough information or insight for a diagnosis. The procedure may also be used to take a biopsy, or sample of tissue, from a particular organ in the abdomen.
Your doctor may recommend a laparoscopy to examine the following organs:
By observing these areas with a laparoscope, your doctor may detect:
Your doctor may also be able to perform an intervention to treat your condition immediately after diagnosis.
The most common risks associated with a laparoscopy are bleeding, infection, and damage to organs in your abdomen. However, these are rare occurrences.
After your procedure, it’s important to watch for any symptoms of infection. Contact your doctor if you experience:
There is a small risk of damage to the organs being examined during a laparoscopy. Blood and other fluids may leak out into your body if an organ is punctured. In this case, you’ll need another surgery to repair the damage.
Less common risks include:
In some circumstances, your surgeon may believe the risk of a diagnostic laparoscopy is too high to warrant the benefits of using a minimally invasive technique. This situation often occurs for people who’ve had prior abdominal surgeries, which increases the risk of forming adhesions between structures in the abdomen.
Performing laparoscopy in the presence of adhesions can take much longer and increases the risk of injuring organs.
You should tell your doctor about any prescription or over-the-counter medications you’re taking. Your doctor will tell you how they should be used before and after the procedure.
Your doctor may change the dose of any medications that could affect the outcome of a laparoscopy. These drugs include:
You should also tell your doctor if you’re pregnant or think you might be pregnant. This will reduce the risk of harm to your developing baby.
You’ll probably need to avoid eating and drinking for at least 8 hours before a laparoscopy. You should also arrange for a family member or friend to drive you home after the procedure. A laparoscopy is often performed using general anesthesia, which can make you drowsy and unable to drive for several hours after surgery.
A laparoscopy is usually done as an outpatient procedure. This means that you can go home the same day as your surgery in many cases. It may be performed in a hospital or an outpatient surgical center.
You’ll likely be given general anesthesia for this type of surgery. This means that you’ll sleep through the procedure and typically won’t feel any pain. To achieve general anesthesia, an intravenous (IV) line is inserted in one of your veins. Through the IV, your anesthesiologist can give you special medications and well as provide hydration with fluids.
During a laparoscopy, the surgeon makes an incision below your belly button, and then inserts a small tube called a cannula. The cannula is used to inflate your abdomen with carbon dioxide gas. This gas allows your doctor to see your abdominal organs more clearly.
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Once your abdomen is inflated, the surgeon inserts the laparoscope through the incision. The camera attached to the laparoscope displays the images on a screen, allowing your organs to be viewed in real time.
The number and size of incisions depends upon what specific diseases your surgeon is attempting to confirm or rule out. Generally, you get from one to four incisions that are each between 1 and 2 centimeters in length. These incisions allow other instruments to be inserted.
For example, your surgeon may need to use another surgical tool to perform a biopsy. During a biopsy, they take a small sample of tissue from an organ to be evaluated.
After the procedure is done, the instruments are removed. Your incisions are then closed with stitches or surgical tape. Bandages may be placed over the incisions.
When the surgery is over, you’ll be observed for several hours before you’re released from the hospital. Your vital signs, such your breathing and heart rates, will be monitored closely. Hospital staff will also check for any adverse reactions to the anesthesia or the procedure, as well as monitor for prolonged bleeding.
The timing of your release will vary. It depends on your overall physical condition and your body’s reaction to the surgery. In some cases, you may have to remain in the hospital overnight.
A family member or friend will need to drive you home if you received general anesthesia. The effects of general anesthesia usually take several hours to wear off, so it can be unsafe to drive after the procedure.
In the days following a laparoscopy, you may feel moderate pain and throbbing in the areas where incisions were made. Any pain or discomfort should improve within a few days. Your doctor may prescribe medication to relieve the pain.
It’s also common to have shoulder pain after your procedure. The pain is usually a result of the carbon dioxide gas used to inflate your abdomen to create a working space for the surgical instruments. The gas can irritate your diaphragm, which shares nerves with your shoulder. It may also cause some bloating. The discomfort should go away within a couple of days.
You can usually resume all normal activities within a week. You’ll need to attend a follow-up appointment with your doctor about 2 weeks after a laparoscopy.
Abnormal results from laparoscopy indicate certain conditions, including:
Your doctor will schedule an appointment with you to go over the results. If a serious medical condition was found, your doctor will discuss appropriate treatment options with you and work with you to come up with a plan for addressing that condition.
The origins of laparoscopic surgery trace back to the introduction of diagnostic laparoscopy in the s. Subsequently, the approach underwent a notable evolution, transitioning from a primarily diagnostic procedure to a surgical technique. Laparoscopic surgery has become the gold standard for treating many pathologies such as symptomatic cholelithiasis, Crohn’s disease, and benign ovarian cysts.1, 2, 3 Laparoscopy, a type of minimally invasive surgery, was introduced to address issues related to significant tissue trauma, large cosmetic scars, and prolonged hospitalizations. Various studies have demonstrated that patients undergoing laparoscopic surgery have reduced risks of perioperative mortality and postoperative morbidity in comparison to individuals undergoing open surgery.4, 5 In order to achieve safe and effective surgical outcomes, the operators are required to have an in-depth understanding of the basic and specialized equipment required.
This video provides a step-by-step demonstration of the assembly, disassembly, use, and handling of laparoscopic tools on the example of a basic Karl Storz laparoscopy kit.
A set of requirements are established to guarantee the efficient handling of the instrument in both the sterilization unit and the operating room. Modern laparoscopic instruments have a distinctive design that enables complete disassembly of each instrument, facilitating efficient cleaning and decontamination. Every modular instrument undergoes validation to ensure that it can be sterilized while fully assembled.
The video begins by introducing the three primary sections of laparoscopic instruments: the insert, the sheath, and the handle. The next part of the video explores three commonly used types of laparoscopic dissectors: the dolphin nose dissector, which has traditional micro-serrated tapered tips; the Maryland dissector with curved forceps, which is ideal for precise manipulations; and the laparoscopic right-angle dissector, which has cross-serrations on its angled tip for grasping tissues in hard-to-reach places. The assembly and disassembly of these dissectors are demonstrated, highlighting the importance of utilizing the tools with non-locking handles to allow for smooth surgeon maneuverability during procedures. The instruments must be completely opened, and the ratchet must be slid into position to activate the locking mechanism; a clear click is produced upon connection. Subsequently, the operator ensures proper functionality by opening and closing the instrument. When the surgeon slides a specific piece down, the ratchet comes into operation. When closed, the ratchet facilitates a secure hold, maintaining the closed position until intentionally released. The removal process involves opening the ratchet, pressing down on a designated button, and effortlessly sliding the handle off. The disassembly of the instrument is completed by twisting and separating the insert from the sheath. This modular design allows for convenient cleaning, maintenance, and potential replacement of individual components.
Next, the video provides a visual overview of medical graspers, which come in numerous variants, distinguished by the inner side of their jaws. Traumatic graspers feature deep serrations or toothed tips for secure gripping, ideal for rigorous procedures. On the other hand, atraumatic graspers have finely serrated inner jaws, providing a gentler touch suitable for delicate tasks involving fragile tissues. The importance of locking handles for graspers, particularly in situations requiring a secure grip, is visually underscored.
A distinctive feature explored in the video is the integration of a Bovie, an electrosurgical device, with laparoscopic instruments. Viewers are visually guided through the steps of connecting the Bovie cord to the laparoscopic instrument handle, demonstrating the technique of efficient cauterization.
The sterilization of laparoscopic instruments is crucial, with procedures varying based on safety standards dictated by different countries. Before sterilization, these instruments undergo a meticulous process, including wiping down and spraying with enzymatic cleaner. An enzyme-based cleaner is an enzymatic detergent solution, penetrating the hard-to-reach parts of the equipment for thorough cleaning. This detergent offers distinct advantages, such as increased activity on proteins (like blood, feces, and mucous) through proteolytic enzymes, advanced formulations for quick and thorough penetration of organic matter, and a safe, biodegradable base that is gentle on both users and the environment. Following the cleaning process, items designated for disinfection must undergo a thorough rinse to remove any residual detergent. Subsequently, the instruments proceed to the final phase of sterilization.
This video is meant as an informative guide to laparoscopic instruments in the field of surgical technology. The step-by-step visual guidance through the assembly, use, and decontamination processes enhances the understanding of laparoscopic instruments.
Check out the complete series below: