Questions and Answers
What is the rate of CO2 delivery during insufflation?
Which method of establishing pneumoperitoneum involves incising through the umbilicus?
What could lead to hypercarbia during CO2 insufflation?
Which of the following is a common anesthetic consideration during minimally invasive surgery?
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Which of the following is NOT a safety concern associated with CO2 insufflation?
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What is the primary benefit of minimally invasive surgery compared to open surgery?
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Which type of instrument is essential for creating access ports in minimally invasive surgery?
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What must be done to the camera used during endoscopic surgery?
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What is the purpose of pneumoperitoneum during minimally invasive surgery?
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Which of the following terms refers to surgery performed through natural orifices?
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What is a key consideration when using light sources and fiberoptic cables during surgery?
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What is the function of a clip applier in minimally invasive surgery?
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Why must the nursing team prepare open instrumentation for all MIS surgeries?
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Study Notes
Definition and Terminology
- Minimally Invasive Surgery (MIS) uses technology to avoid large incisions.
- Synonyms include endoscopic surgery, laparoscopic surgery, and natural orifice transluminal endoscopic surgery (NOTES).
MIS Versus Open Surgery
- MIS procedures generally lead to reduced recovery times and lower pain levels compared to open surgery.
Endoscopic MIS Instrumentation
- Endoscopes: Available in flexible, rigid, and semirigid forms; used for both diagnostic and operative purposes.
- Light Sources: Essential for visibility; should be used with caution to avoid contact with flammable materials.
Trocar System
- A trocar system allows safe entry into the abdominal cavity; consists of an obturator and a sleeve (cannula).
- Steps for insertion: Insert obturator and sleeve, then remove obturator, leaving the sleeve in place.
Camera Utilization
- The camera is a non-sterile device requiring draping with a sterile sleeve by the scrub nurse to maintain sterility during surgery.
Additional Instruments
- Clip Appliers: Can be disposable or re-usable.
- Endocatch Retrieval Device: Used for capturing tissues or specimens.
- Stapling Device: Utilized in various surgical procedures.
Video Technology Components
- Essential components include endoscope, light source, camera head, and video monitor; crucial for visualizing surgical field during MIS.
Robotics in Surgery
- Utilizes advanced technology to assist in surgical procedures, enhancing precision and control.
Pneumoperitoneum
- Created with CO2 gas for better visualization of abdominal structures; typical flow rates are 15-20 liters per minute with pressures of 14-16 mm Hg.
Establishing Pneumoperitoneum
- Closed Method: Utilizes a Verres needle to insufflate CO2, confirmed by negative bowel and blood return.
- Open Method: Requires incision through the umbilicus and placement of a Hasson Trocar for access.
Safety Considerations
- Overpressurization can lead to complications such as hypercarbia and decreased cardiac output.
- Compression on the abdomen or additional gas sources can exacerbate issues.
Anesthetic Considerations
- Potential complications include hypothermia, hypoxia, CO2 gas emboli, and pneumoscrotum, which may arise during MIS procedures.
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Description
This quiz explores key concepts in minimally invasive surgery (MIS), including the definition of endoscopic surgery and the usage of common endoscopic instruments. Participants will learn about pneumoperitoneum, potential complications, and the process of converting MIS to open surgery. Test your knowledge on this advanced surgical technique!
