Lecture 23 - Minimally Invasive Surgery Flashcards Preview

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Flashcards in Lecture 23 - Minimally Invasive Surgery Deck (33)
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1

Minimally invasive surgery _____ damage to tissues.

reduces

2

Minimally invasive surgery is performed via _____ incisions; is not "_____".

smaller, open

3

Minimally invasive surgery usually involves a _____. What is the suffix for a procedure like this?

camera, -oscopy

4

Endoscopy was started by who? What did this person do?

Philipp Bozzini;

Developed a light conductor called the Lichtleiter and directed light into the internal cavities of the body

5

What are 5 advantages to MIS?

  1. Less blood loss (can visualize better)
  2. Less scarring and less damage to body
  3. Shorter hospital stays
  4. Decreased pain
  5. Earlier resumption of normal activities

6

What are 3 main disadvantages of MIS?

  1. Operations may last longer (greater learning curve for surgeon and requires advanced training)
  2. Operations may cost more (equipment is costly)
  3. May be more difficult for the surgeon

7

What are 7 other disadvantages to MIS?

  1. $$$
  2. Effects of pneumoperitoneum or pneumothorax
  3. Trocar insertion
  4. Ergonomics
  5. Pressure ischemia during long procedures
  6. Gas emboli
  7. Equipment failure

8

What are some common procedures done by MIS?

Laparoscopy, arthroscopy, endoscopy, cystoscopy, hysteroscopy, biopsies, orthopedic procedures

9

What types of procedures would use a flexible camera?

Colonoscopy, laryngoscopy, bronchoscopy, sinoscopy

10

What types of procedures would use a rigid camera?

Laparoscopy, arthroscopy, thoracoscopy, sinoscopy

11

How does the camera light source connect to the scope?

Through fiberoptic cable

12

What light source is preferred for a camera?

Xenon light source

13

What is the advantage to having a videocamera?

Allows magnification of the view

14

Why do we perform arthroscopy?

Visualize the joint, magnification and fluid medium

15

Arthroscopy is routine treatment for joint diseases in _____ and _____.

dogs, horses

16

What are 4 benefits to using arthroscopy vs. arthrotomy?

  1. Less isruption of periarticular tissue
  2. Earlier return to normal function
  3. Can operate multiple joints at a time
  4. Better cosmetic outcome

17

What is the most common size scope used in horses?

4.0 mm

18

What is the most common size scope used in dogs?

2.7 mm

19

What angle is favored by arthroscopists?

20-30 degrees

20

What are cannulas used for?

Allow the arthroscope to be inserted into the joint, protects it from bending or breaking

21

What instruments are used for arthroscopy?

Probe, curettes, grasping forceps

22

Why do we use fluids during arthroscopy?

Pressure controls hemorrhage

Flattens synovial membrane and distends joints to provide greater visualization

Removes debris

23

Why do we induce a pneumoperitoneum and what gases can be used?

Distends area so you can see;

CO2, air, oxygen, N2O, argon, helium, mixtures

24

Why is CO2 the best choice for insufflation?

  1. High diffusion coefficient
  2. Normal metabolic end product
  3. Rapidly cleared
  4. Highly soluble in blood and tissues
  5. Does not support combustion
  6. Risk of gas embolism low

25

What gas is preferred in patients with cardiac disease and why?

N2O due to possible induced hypercarbia with CO2

26

What pressure is safe for pneumoperitoneum?

15 mm Hg or less

27

What diameter vessel can Ligasure be used on?

7mm or less

28

What procedures can be done laparoscopically?

Biopsy, hernia repair, closure of nephrosplenic space/epiploic foramen, cryptorchid neuter, ovariectomy, gastropexy, abomasopexy

29

What instruments can be inserted into an endoscope through the biopsy channel?

Biopsy forceps, baskets for FB retrieval, laser for tissue resection and cautery

30

What orthopedic procedure can be done with MIS?

Fracture repair