Laparoscopic Sx Flashcards
What is MIS?
Minimal invasive surgery that results in less tissue trauma compared to open surgery (laparoscopy).
Devices that provide laparoscopic peritoneal access:
Veress needle
Modified Hasson
Mini- laparotomy [SILS]
Of the three Modified Hasson is safest and preferred!
Why is CO2 used as an insufflator?
Because air makes emboli in arterial system & is flammable
Telescope angles and when to you them
0 degree- easiest to move and can use with simple procedures ( not looking down corners)
30 degree- better with more complicated procedures because have wider FOV
What are 3 main instruments used in laparoscopic procedures?
Babcok, Metzenbaum scissors and Kelly forceps
What are the bipolar sealant advantages?
Low voltage; high current
Can seal vessels > 7mm and resist pressure 300 mmhg
No patient return b/c send current between jaws
What is a harmonic scalpel?
It cut, desiccates and coagulates via mechanical energy (vibrating)
- pro: no current used so less concern for ventricular fibrillation
Physiologic effects of abdominal insufflation
Pressure placed against diaphragm & vena cava
- decreases thoracic compliance (venous return)
- decreases TV & CO
Results in hypoventilation, hypoxemia, acidemia
How to avoid issues associated with abdominal insufflation?
Limit intra-abdominal pressure
Dogs < 12 mmHg
Cat <8 mmHg
Pain sources associated with laparoscopic procedures
Incisions, peritoneal CO2 (acidosis & non-humidified causing desiccation peritoneum) & stretching diaphragm (neuropraxia)
OVH vs OHE?
Either, but OHE is more challenging laparoscopy and does not need to be done unless uterine problem!
Why does pyometra occur during diestrus?
Progesterone
This makes uterine myometrium flaccid and tightens the cervix
What port is preferred with lapOVE?
2 port technique
What is triangulation in lap sx?
Center- tissue
Surgeon- front
Sides- ports
Monitor- in front
Conversion from LapOVE to open procedure is a complication?
No
