World Laparoscopy Hospital Essentials of Laparoscopic Surgery

Port Position in MAS

R. K. Mishra

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World Laparoscopy Hospital Essentials of Laparoscopic Surgery

Where Should I

Put my Port?

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World Laparoscopy Hospital Essentials of Laparoscopic Surgery

Statistics

The most

common

cause of

stressful

surgery is

wrong port

position

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World Laparoscopy Hospital Essentials of Laparoscopic Surgery

Is Umbilicus Safe For Primary

Port ?

•Wound infection at the

umbilicus is similar to

that at other sites

•Postoperative ventral

hernia at the umbilicus

is similar to that at other

sites

The central location and ability of the umbilicus to camouflage scars make it an

attractive primary trocar site for laparoscopic surgery.

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World Laparoscopy Hospital Essentials of Laparoscopic Surgery

For Operative Surgery Follow

Base Ball Diamond Concept

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World Laparoscopy Hospital Essentials of Laparoscopic Surgery

First Decide the Target

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World Laparoscopy Hospital Essentials of Laparoscopic Surgery

Find The Length Of Your

Instrument

Size of Adult Laparoscopic Instrument is

36 Cm & Paediatrics Instrument is 28 cm

For optimum task

performance the

half to two third

instrument should

be inside the

abdomen

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World Laparoscopy Hospital Essentials of Laparoscopic Surgery

18 cm

24 cm

Draw The Line Of Optimum

Area

Draw two arcs on

the abdominal wall

at 18 and 24 cm

from that point and

note the area in

between

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World Laparoscopy Hospital Essentials of Laparoscopic Surgery

Telescope & Instruments

1.Telescope should

be in the middle of

instruments

2.Manipulation angle

of instruments

should be 60

degree

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World Laparoscopy Hospital Essentials of Laparoscopic Surgery

“Baseball Diamond” Concept

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World Laparoscopy Hospital Essentials of Laparoscopic Surgery

Rule Of Diamond

18 cm

24 cm

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World Laparoscopy Hospital Essentials of Laparoscopic Surgery

Rule Of Diamond

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World Laparoscopy Hospital Essentials of Laparoscopic Surgery

Laparoscopic Appendectomy

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World Laparoscopy Hospital Essentials of Laparoscopic Surgery

Laparoscopic Hernia

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World Laparoscopy Hospital Essentials of Laparoscopic Surgery

Drawing with Surgical Sketch

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World Laparoscopy Hospital Essentials of Laparoscopic Surgery

“Baseball Diamond” concept

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World Laparoscopy Hospital Essentials of Laparoscopic Surgery

Splenectomy

“Baseball Diamond” concept

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World Laparoscopy Hospital Essentials of Laparoscopic Surgery

If There Are Two Targets ?

That part of the abdominal wall which is common to the two areas marked is

the best site for the ports.

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World Laparoscopy Hospital Essentials of Laparoscopic Surgery

Rule of

Diamond

Not

Always

Applicable

Retroperitoneoscopy

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World Laparoscopy Hospital Essentials of Laparoscopic Surgery

Rule Not Applicable Always

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World Laparoscopy Hospital Essentials of Laparoscopic Surgery

Hemi-Nephroureterectomy

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World Laparoscopy Hospital Essentials of Laparoscopic Surgery

Thank you

Our Advance course at Iranian Hospital, Dubai