laparoscopic instruments & tower 5 th practice department of surgical research and techniques
TRANSCRIPT
Laparoscopic Instruments & Tower
5th PracticeDepartment of Surgical
Research and Techniques
Requirements:1. Laparoscopic Tower – Parts and Functions 2. Usage of the Laparoscopic Instruments3. Practice on the Pelvitrainer
5th PracticeDepartment of Surgical
Research and Techniques
Laparoscopic Tower
Diathermy (mono- and bipolar diathermy)
Monitor
Light source Camera control unit
Insufflator Suction-irrigation system
Video recorderRoller stand
5th PracticeDepartment of Surgical
Research and Techniques
Pneumoperitoneum
Lifting the abdominal wall by insufflation with carbon dioxide gas
Department of Surgical
Research and Techniques
5th Practical
Veres needle
Connection ofinsufflator tube
Sharp outer cannula
Spring-loaded inner stylet with a blunt tip
Inlet for gas
Proper handling position
5th PracticeDepartment of Surgical
Research and Techniques
Insufflator
Intraabdominalpressure (mmHg)
Gas flow(liter/min)
Amount of the used gas (liter)
Antibacterial filter
Disposable insufflator tubing
Amount of gas in the gas-tank
Power switch
5th PracticeDepartment of Surgical
Research and Techniques
Trocars
Outer diameter 5 mm -10 mmInner cannula/ Sharp
Valve
Switch
Outer cannula is blunt/ Port
5th PracticeDepartment of Surgical
Research and Techniques
5th PracticeDepartment of Surgical
Research and Techniques
Safety Trocars
Corkscrew trocar Sharp and blunt shafts
Spring-loaded plastic shield
5th PracticeDepartment of Surgical
Research and Techniques
Trocar Insertion
The first trocar is inserted blindly, usage of safety trocars is mandatory!
5th PracticeDepartment of Surgical
Research and Techniques
Light Source
Degree of brightness
Brightness adjustment Fibre-optic cablePower switch
5th PracticeDepartment of Surgical
Research and Techniques
Check the light cable before use!
Telescopes
Traditional &
Hopkins Telescopes with rod lens and
fibers
optikai lencsék
quartz rúd-lencse
Length: 30 cmDiameter: 5 mm, 10 mmDegree: 0°, 30°, 45°
5th PracticeDepartment of Surgical
Research and Techniques
Telescopes
Objective lens (0° 30°45°)Light cable connection
The field of view can be changed by the rotation of the light cablein 30 and 44 degree telescopes
Camera
5th PracticeDepartment of Surgical
Research and Techniques
Ocular (camera connection)
Camera Controller
Camera
Power switch
Camera plug in
5th PracticeDepartment of Surgical
Research and Techniques
Telescope (bajonet) joint
Programing /White balance
Zoom ring
Focus ring
Cabel to the controller
Camera Head 5th PracticeDepartment of Surgical
Research and Techniques
Optical System
Light Source
Telescope
Camera
Camera Controller
Video Cable Video Recorder
Monitor
Surgical Team
5th PracticeDepartment of Surgical
Research and Techniques
Diathermy Controller 5th PracticeDepartment of Surgical
Research and Techniques
Double pedal footswitch
Mono- & Bipolar diathermy
Power switch
Bipolar diathermy forceps
Indifferent electrode pad
DiathermyDiathermy 5th PracticeDepartment of Surgical
Research and Techniques
Forceps head Forceps head
Insulation
++--
Monopolar
Hook
++
Bipolar
DiathermyDiathermy 5th PracticeDepartment of Surgical
Research and Techniques
Forceps head Forceps head
Insulation
++--
Monopolar
Hook
++
Bipolar
Insulated & Non-insulated handles
!
Suction(Hgmm)
Irrigation(Hgmm)
Sterile saline
Collected bottle for aspirated materials
Suction-Irrigation System
Hand piece/ Shaft
5th PracticeDepartment of Surgical
Research and Techniques
Suction-Irrigation SystemSuction-Irrigation System5th PracticeDepartment of Surgical
Research and Techniques
Tubing
Multiple perforationThree-channel tube
5th PracticeDepartment of Surgical
Research and Techniques
Dissectors & Grasping forceps
Biopsy forceps Ratchet
Pistol-grip handle
BabcockBowel Allis
Parts:handleouter tubeworking insert
Instruments II. II.
Metzenbaum scissors, Hook scissors, Biopsy forceps
5th PracticeDepartment of Surgical
Research and Techniques
Clip applier
Unifying Instruments
Staplers
5th PracticeDepartment of Surgical
Research and Techniques
Suturing InstrumentsSuturing Instruments
Szabó-Berci needle holdersSzabó-Berci needle holders
Coaxial handle
Parrot-Jaw needle holder
Flamingo-Jaw assistant needle holder
5th PracticeDepartment of Surgical
Research and Techniques
Some pictures of this lecture are presented by
courtesy of Zoltán Szabó Ph.D.
5th PracticeDepartment of Surgical
Research and Techniques
Two dimensional approach and three dimensional activity
Eye-hand coordination Feeling deepth Coordinate use of dominant and nondominant hand Lack of tactile sensation Magnifient surgical territory – finer manipulation Limitted movement Unusual instruments
Department of Surgical
Research and Techniques
5th PracticeDepartment of Surgical
Research and Techniques
Difficulties of laparoscopic technique