Diagnostic Laparoscopy

Alexander Parata

Diagnostic Laparoscopy- a procedure that allows a health care

provider to look directly at the contents of a patient's abdomen or pelvis, including the fallopian tubes, ovaries, uterus, small bowel, large bowel, appendix, liver, and gallbladder.

Basic Equipment

•Camera/Laparoscope•Video Monitor•Insufflator•Light source•ESU•Stirrups

Basic Instruments

•Laparotomy set•Laparoscopy set•Vaginal Tray

Auvard Weighted Speculum Sims Uterine sound Cervical dilators Tenaculum forceps

Pre Op

•Anesthesia : General/local•Position: lithotomy •Prep: Laparotomy + Vaginal Prep•Draping: Laparotomy + Lithotomy drapes

▫1x urethral catheterization done prior to prep

Basic Laparoscopy Procedures

1. Handheld vaginal retractor (Auvard Weighted Speculum) placed posteriorly in the vagina and the cervix is grasped with a tenaculum.

2. Uterine manipulator is placed into cervix.

3. Anterior abdominal wall is elevated (use 2 towel clips)

4. Midline incision is made with #11 blade.

5. Veress Needle in inserted to fascia in order to enter the abdominal cavity.

6. abdominal cavity is inflated with 3 liters of CO2 (pressure 12-15 mmHg)

7. Remove veress Needle and extend the incision to 1 cm (length). To insert Laparoscopic trocar+Sleeve into the abdominal cavity.

8. The trocar is removed from the sleeve and is replaced with at laparoscope.

- co2 line connected to valve on sleeve-laparoscope connected w/ light source, camera, monitor.

9. After operative intervention the CO2 is released and all ports are removed.

10. Close incision (suture/steri strips)

Post Op

•PACU•Return to normal activities

Possible COMPLICATIONS:-Hemorrhage-Wound infection-Perforation of viscus