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Flashcards in Endoscopes Deck (41)
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1
Q

What is endoscopic surgery?

A

Minimally invasive surgery

  • small incisions
  • computer assisted
  • digitak imaging/data

Endoscopes can be rigid or flexible for visualizing the interior of a hollow organ or part for diagnostics and surgical purposes

Has channels to enable passage of instruments

2
Q

Benefits to endoscopic surgery?

A
Decrease risk of SSI
Fast recovery 
Decrease post op pain
Decrease tissue trauma 
Decrease blood loss
Short stays 
Decrease adhesions
3
Q

Bioburden?

A

The number of viable organisms contaminating an object

4
Q

Biofilm?

A

Accumulated biomass of bacertia and extra cellular material that is tightly adhered to a surface

Difficult to remove

5
Q

What is borescope?

A

A device used to inspect the inside of an instrument through a small opening or lumen of the instrument

6
Q

What is extravasation?

A

To pass by infiltration of effusion from a vessel or channel into surrounding tissue

Edema, abd distension, intra abd compartment syndrome

7
Q

High level disinfection?

A

Processes that kill all microbial pathogens but not necessarily all bacterial spores

8
Q

What is insufflation?

A

The act of blowing gas into a cavity for the purpose of visual examination

9
Q

What is larparoscopic surgery?

A

Minimally invasive surgery

  • port site
  • instruments inserted to perform surgery

Laparoscope is inserted through an incision in abdominal wall and used to visually examine the interior of peritoneal cavity

10
Q

What is a mechanical processor?

A

Mechanically cleans, rinses and exposes flexible endoscopes and accessories to a high level disinfectant or liquid chemical sterilant

11
Q

What is covered under minimally invasive surgery?

A
Surgeries performed one or more small incisions 
Radiographic and MRI
Computer assisted devices
Robotics 
And other technologies
12
Q

What is a port site?

A

A small incision that a trocar is inserted for placement of cannula into a body cavity or body part

13
Q

What is pneumoperitoneum?

A

The presence of air or gas within the peritoneal cavity of abd

14
Q

What is a no fly zone?

A

Area for safe use of imaging and other equipment

No staff should in area

Safety precaution

15
Q

What is sterilization?

A

Processes by which all microbial life are killed

Pathogenic, nonpathogenic and spores

16
Q

What do video towers contain?

A
Video monitor
Light source
Camera control
Suction or insufflation
Suction irrigation system
Esu
Gas cylinders
Devices for recording
17
Q

What does white balance do?

A

Adjusts white, red, green and blue colours to appear as natural as possible

Hold camera 2 inch away from surface and press white balance button

18
Q

Recording systems for endoscopes?

A

Must follow HIPPA for storage

Can take pics, store data and print/transfer data

19
Q

What is an endoscope?

A

A tube inserted into a natural body orifice or through a small incision to access organs/structures

Rigid or flexible

Surgical or diagnostic

20
Q

External light for endoscopic surgery?

A

Requires to visualize

Fiberoptic light = ignition source
*fire safety

Components: light source, cable with light at end and inserted into channel

21
Q

Fire safety for light source?

A

No contact with pstient skin or flammable material

Do not rest on drapes

Turn off or place in standby

22
Q

What are trocars?

A

Access operative site

Consists of:
obturator - sits inside cannula snd created orifice and removed

Cannula - hollow cylinder that surgical instruments are places through

23
Q

What are dissecting instruments?

A

Scissors

  • blunt or sharp
  • straight or curved
  • may connect to ESU to coag
  • round tip to dissect w/o truma

Maryland

  • seperare/divides tissue
  • different shapes to spread, divide, grasp, retract, coag
24
Q

Clamping instruments?

A

Dolphin grasper
Toothed grasper
Cup forceps

  • traumatic = teeth
  • atraumatic = smooth, serrated jaw
  • biopsy = used for tissue collection
25
Q

Suturing/stapling instruments?

A

Hold and secure

Needle holder
Clip applier
Surgical stapler

26
Q

What is insufflation gases?

A

During laproscopic surgery gas in inserted into peritoneal cavity to create pneumoperitoneum
- working space

27
Q

Most common insufflation gas?

A

CO2

  • easily dissolved
  • colourless
  • odourless
  • cheap
  • non flammable
28
Q

Examples of insufflation gases?

A
CO2 - most common
Air - not easily absorbed 
Nitrogen
Nitrous oxide 
Argon - depresses hemodynamics conpared to CO2
Helium - less soluable compared to CO2
29
Q

Potential complicationsof gas insufflation?

A
Increase BP
Cardiac arrhythmias
Decreased cardiac output 
Acidosis 
Gas embolism 
Hypercarbia
Decreased bloodflow to kidneys 
Peritoneal irritation
Decrease urine output
30
Q

Safety considerations for gas insufflation?

A

Place insufflator above level of surgical cavity

Hydrophobic filter is placed between insufflator and tubing

Flush with gas before connecting to cannula

Alarms audible

31
Q

How should insufflation gas pressure be set?

A

Lowest level necessary to maintain pneumoperitoneum for adequate visibility

Normally < 15mmHg

32
Q

Intra abd gas embolism?

A

Increased abd pressure
Open blood vessels allow gas to enter circulatory system

S&S:

  • hypotension
  • dyspnea
  • cyanosis
  • cardiac anomalies
33
Q

What to do if Intra abd gas embolism occurs?

A
D/c gas 
D/c anestheic agents
Trendelenburg or left lateral position 
IV fluids 
Meds to improve pulmonary circulation 
CPR
34
Q

Gas cylinder safety considerations?

A

Correct gas

  • label
  • connector
  • colour coding

Enough gas in cylinder
Correct key
Cylinders in open position
Second cylinder readily available

35
Q

What is irrigation and distension media?

A

Fluids are instilled bu gravity or by infusion pump into body cavity or joint space

Selected by:

  • type of procedure
  • pt assessment
  • instruments to be used
36
Q

What is intravasation?

A

When irrigation or distension fluids are abdorbed into pt blood stream

  • hyponatremia, hypervolemia, cardiovascular/pulmonary complications
  • transurethral resection syndrome
37
Q

Low viscosity non electrolyte fluids?

A

Used for monopolar
Hypotonic
Cause cause TUR syndrome

Ex:
1.5% glycine, 5% mannitol, 3% sobitol

38
Q

NS fluids?

A

Common with bipolar
Isotonic
Contains electrolytes
Safer if absorbed

39
Q

High viscosity fluid?

A

Plasma volume explander
- can draw 6x its own vojnd into bloodstream
Provides good visibilty when bleeding occurs
Contains glucose content
Can cause significant complication
- fluid overload, heart failure, pulm edema
Needs fo be rinsed/flushed with sterile water after use

Ex. Dextran

40
Q

Preventing thermal injuries from fluids?

A

Store as per manufacturer instructions

Keep seperate from blankets

Label irrigation fluids with date that it was put in warmer and expiration date

41
Q

Patient considerations for laparoscopic sx?

A
Previois incision 
- trocar insertion 
Hx of DVT
- positioning decreases venous return
Consent
- may need to open
Voiding prior to sx 
- helps avoiding puncturing with trocar