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Questions and Answers
What is the primary purpose of using minimally invasive surgery techniques?
What is the primary purpose of using minimally invasive surgery techniques?
- To require larger incisions
- To increase postoperative discomfort
- To prolong hospital stays
- To minimize recovery time and complications (correct)
Which of the following terms refers specifically to surgery performed through a single incision?
Which of the following terms refers specifically to surgery performed through a single incision?
- Natural orifice transluminal endoscopic surgery
- One port umbilical surgery
- Minimal access surgery
- Single incision laparoscopic surgery (correct)
What is a potential disadvantage of minimally invasive surgery for hospitals?
What is a potential disadvantage of minimally invasive surgery for hospitals?
- High costs of equipment and supplies (correct)
- Requirement for larger surgical teams
- Increased surgical complications
- Longer patient recovery times
What does pneumoperitoneum refer to in the context of minimally invasive surgery?
What does pneumoperitoneum refer to in the context of minimally invasive surgery?
Which benefit do patients typically experience following minimally invasive surgery?
Which benefit do patients typically experience following minimally invasive surgery?
What is the main function of the laparoscope in minimally invasive surgery?
What is the main function of the laparoscope in minimally invasive surgery?
What is a consideration the nursing team must have when preparing for minimally invasive surgery?
What is a consideration the nursing team must have when preparing for minimally invasive surgery?
Which of these is NOT considered an advantage of minimally invasive surgery?
Which of these is NOT considered an advantage of minimally invasive surgery?
What is the preferred gas used to achieve pneumoperitoneum?
What is the preferred gas used to achieve pneumoperitoneum?
What is the desired intra-abdominal pressure range for laparoscopic procedures?
What is the desired intra-abdominal pressure range for laparoscopic procedures?
What is the primary function of a trocar system in endoscopic procedures?
What is the primary function of a trocar system in endoscopic procedures?
Which method for creating pneumoperitoneum utilizes the Verres needle?
Which method for creating pneumoperitoneum utilizes the Verres needle?
Which type of trocar is most commonly used and requires disassembly for processing?
Which type of trocar is most commonly used and requires disassembly for processing?
What can result from administering an insufficient amount of CO2 during the insufflation process?
What can result from administering an insufficient amount of CO2 during the insufflation process?
What distinguishes disposable from non-disposable clip appliers in endoscopic procedures?
What distinguishes disposable from non-disposable clip appliers in endoscopic procedures?
Why is carbon dioxide chosen over simple room air for pneumoperitoneum?
Why is carbon dioxide chosen over simple room air for pneumoperitoneum?
What is the main purpose of using endoscopes in surgical procedures?
What is the main purpose of using endoscopes in surgical procedures?
What is the role of an insufflator in laparoscopic procedures?
What is the role of an insufflator in laparoscopic procedures?
Which method is commonly used to create a pneumoperitoneum during minimally invasive surgery?
Which method is commonly used to create a pneumoperitoneum during minimally invasive surgery?
What can excessive intra-abdominal pressure lead to during laparoscopic surgery?
What can excessive intra-abdominal pressure lead to during laparoscopic surgery?
What is the role of the endocatch instrument during endoscopic surgery?
What is the role of the endocatch instrument during endoscopic surgery?
Which factor can increase intra-abdominal pressure during surgery?
Which factor can increase intra-abdominal pressure during surgery?
What must the nursing team prepare before minimally invasive surgery?
What must the nursing team prepare before minimally invasive surgery?
Endoscopic sutures are referred to by which term?
Endoscopic sutures are referred to by which term?
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Study Notes
Minimally Invasive Surgery (MIS) Overview
- Minimally Invasive Surgery (MIS) involves procedures performed using technology like a laparoscope, reducing the need for large incisions.
- Terms like endoscopic, laparoscopic, and minimally invasive surgery are often used interchangeably.
Key Terminology
- MAS/MIS: Minimal Access Surgery / Minimally Invasive Surgery.
- SPA: Single Puncture Access.
- SILS: Single Incision Laparoscopic Surgery.
- NOTES: Natural Orifice Transluminal Endoscopic Surgery.
Advantages of MIS
- Patients benefit from shorter hospital stays and quicker recovery times.
- Leads to reduced postoperative pain and fewer complications (e.g., wound infections, scarring, adhesions).
- Hospitals can lower costs linked to shorter stays and decreased infection rates.
Disadvantages of MIS
- High costs associated with specialized equipment and supplies.
- Procedures are technically demanding, requiring skilled nursing staff familiar with MIS instruments and safety protocols.
- Preparedness for potential conversion to open surgery is essential.
Endoscopic Instrumentation
- Laparoscopic instruments share names with open surgery tools (e.g., Babcock, scissors) but feature a long shaft.
- Endoscope: An instrument inserted through a tiny incision or natural orifice, facilitating internal visualization.
- Trocar System: Consists of an obturator and sleeve (cannula) for instrument insertion; includes disposable and reusable options.
Surgical Tools and Equipment
- Clip Appliers: Used to secure vessels without suturing; available in disposable and reusable versions.
- Suture Types: Loop ligatures, extracorporeal, and intracorporeal sutures are used in surgeries.
- Endocatch Instrument: Utilized for retrieving contaminated specimens.
- Camera: A non-sterile device requiring sterile draping for visualization.
Pneumoperitoneum
- Pneumoperitoneum involves inflating the abdominal cavity with CO2 using an insufflator.
- CO2 is preferred due to rapid absorption and safety; it prevents combustion risks associated with room air.
- The pneumoperitoneum can be achieved via closed method (Verres needle) or open method (Hassan Trocar).
Insufflation Process
- Insufflation separates organs, minimizing the risk of tissue perforation.
- Insufflator systems monitor the flow rate (up to 15-20 L/min) and volume (2.5-4 L, adjusted for patient size).
- Desired intra-abdominal pressure for laparoscopic procedures is 14-16 mmHg.
Safety Considerations
- Overpressure can lead to gas embolus and complications like hypercarbia or respiratory acidosis.
- End-tidal CO2 monitoring detects excess CO2 absorption.
- Factors increasing pressure include external abdominal pressure and additional gas sources (e.g., argon beam coagulator).
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