INSTRUMENTS AND Pneumoperitoneum .


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INSTRUMENTS AND Pneumoperitoneum. Dr. Anmar Nassir, FRCS(C) Fellowship in Andrology (U of Ottawa) Fellowship in EndoUrology and Laparoscopy (McMaster Univ) Chairman, Department of Surgery Umm Al-Qura Univ Consultant Urology, King Faisal Specialist Hospital, Jeddah.
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INSTRUMENTS AND Pneumoperitoneum

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Dr. Anmar Nassir, FRCS(C) Fellowship in Andrology (U of Ottawa) Fellowship in EndoUrology and Laparoscopy (McMaster Univ) Chairman, Department of Surgery Umm Al-Qura Univ Consultant Urology, King Faisal Specialist Hospital, Jeddah

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There are 4 fundamental procedures used to make pneumoperitoneum : daze Veress needle coordinate trocar inclusion optical trocar addition open laparoscopy Gu¨nenc et al. Surg Laparosc Endosc Percutan Tech, 2005

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In 578 laparoscopic strategies: daze inclusion of the Veress needle (gather 1, n = 301) coordinate trocar addition with height of the rectus sheath utilizing 2 towel cuts (amass 2, n = 277). Gu¨nenc et al. Surg Laparosc Endosc Percutan Tech, 2005

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Results: Total complexity rates: gr 1 = 15.7% (n = 33) gr 2 = 3.3% (n = 4) (P < 0.05) Conclusion: Direct trocar addition with height of the rectus sheath utilizing 2 towel clasps is a simple, safe, and compelling method. Gu¨nenc et al. Surg Laparosc Endosc Percutan Tech, 2005

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Having been a Veress needle advocate all through my vocation, I am reluctant to change. Be that as it may, this experimentally well-done study gives me "delay"; speedier pneumoperitoneum with less entanglements is surely a convincing contention for considering a change. Ralph V. Clayman, J of urol. Pg 1847. Nov, 2005

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Telescopes from 1 mm width and 17.5 cm length up to 10 mm distance across and 42 cm length Longer OR time In get ready or beginning Visualization Instruments

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Laparoscopic instruments

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This reusable three-piece: Available in, 5 mm and 10 mm sizes, with lengths of 20 cm, 30 cm, 36 cm and 43 cm .

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Clips & Staplers Endo-GIA stapler Clips Hem-o-bolt

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Entrapment sack LapSac

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Entrapment pack Endobag (Tyco)

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Instruments Summary Optics ought to be the condition of workmanship. Test work before utilize Familiarize staff with investigating Think financially savvy

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Nephrectomy

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Flexible pyeloscopy for evacuation of caliceal stones utilizing triradial graspers

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The renal pelvis is sewn to the relating corner of the ureter (EndoStitch gadget appeared).

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Auto suturing 6 specialists with laparoscopic experience were prepared on the three suturing methods. A pelvic coach was set up with a crisply stamped and etched swine renal pelvis and ureter 216 bunches Knot was exclusively tried on a Monsanto Model 10 tensiometer (slippage, quality, and breakage focuses) Pattaras et al, J Endourol. 2001 Mar

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Auto suturing Pattaras et al, J Endourol. 2001 Mar

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Comparison b/w diff encounter METHODS: 1) intracorporeal suturing and bunch tying, 2) intracorporeal suturing and extracorporeal tying 3) mechanically helped suture & pretied tie gadget (Quik-Stitch). 3 going to specialists: 1 with much experience 2 with less experience 2 boss occupants, with the slightest experience. Bermas et al, Journal of the Society of Laparoendoscopic Surgeons, 2004 Apr-Jun

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RESULTS: The normal times in sec Bermas et al, Journal of the Society of Laparoendoscopic Surgeons, 2004 Apr-Jun

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