A Guide to Laparoscopic Surgery

A Najmaldin, P Guillou

A Guide to Laparoscopic Surgery presents a basic introduction to the use of laparoscopic techniques in a variety of surgical situations commonly faced by the general surgeon. Using the simplest of means, concise, note-style text, summaries and line illustrations only, the authors - who are both experienced laparoscopists - describe the scope and application of laparoscopic access surgery in a variety of situations. The emphasis is on practicalities throughout.

Preface; SECTION I: INTRODUCTION Introduction/History Definition Advantages of Laparoscopy Disadvantages and limitations of laparoscopy Contraindications/Risk factors Absolute Definition Combined laparoscopy and open surgery Physiological changes during laparoscopy Respiratory Cardiovascular Renal Electrolyte Metabolic Anaesthesia during laparoscopy Postoperative management SECTION 2: EQUIPMENT, INSTRUMENTS AND BASIC TECHNIQUE Instruments and basic technique equipment Camera Monitor Light source Documentation Imaging Trolley Telescope Problems and solutions with imaging and viewing Sterilization and maintenance of optics and camera Instruments and access Introduction Anatomy Insufflator Veress Needle Cannula and Trocars Anchoring Device Creation of pneumoperitoneum/access Gasless laparoscopy Pneumorepitoneum by veress needle Unscarred abdomen Site Technique Safety checks Insufflation Scarred abdomen Problems and solutions of veress needle and pnemoperitoneum Misplaced needle with or without insufflation Complications of pnemoperitoneum Primary cannula insertion Technique Primary cannula in scarred abdomen Problems and solutions of primary cannula Direct primary cannula/trocar insertion Open cannulation (Hasson's technique) Complications of the open technique Secondary cannula Selection Position Technique Problems and solutions of secondary cannula Retraction Extraperitoneal laparoscopy Technique with balloon Technique without balloon Advantages Disadvantages Instrument holder Exiting from the abdomen Problems after exiting Instruments for dissection Grasping forceps Scissors Diathermy/electrocautery Problems and solutions of diathermy Dissection of tissue Manipulation Sharp dissection Blunt dissection Haemostasis Suction/irrigation Problems and solutions Laser CO2 Argon KTP Nd-YAG High intensity focused ultrasound Cavitational aspirator Activated scalpel/shears High velcity water jet Hydrodissector Ligation and suturing instruments Needle holder Needles/sutures Knotting External knotting Internal knotting Ligatures Pre-tied ligature Ligature using an extracorporeal knot Ligature using an intracorporeal knot Suturing Ligature clips Stapling or tacking Linear staplers Sewing device Tissue glue/sealant Specimen extraction Extraction through the cannula Extraction through the cannula site Technique without a bag Problems and solutions Retrieval bag Technique with a bag Problems and solutions Minilaparoscopy for tissue removal SECTION III : SETTING UP IN THEATRE Hand Instruments Equipment Check list Patient Position And Preparation Setting up for the procedure SECTION IV: LAPAROSCOPIC PROCEDURES Diagnostic laparoscopy Indications Instruments Technique Problems and solutions Laparoscopic ultrasonography Advantages Disadvantages Laparoscopic adhesiolysis Indications Instruments Preparation Technique Problems and solutions Laparoscopic Cholecystectomy Indications Instruments Preparation Technique Problems and solutions Complications Management of common bile duct stones Appendectomy Indications Instruments Preparation Technique Problems and solutions Laparoscopic Nissen's fundoplication Indications Contraindications Instruments Preparation Technique Problems and solutions Laparoscopic gastroenterostomy Indications Preparation Instruments Technique Problems and solutions Complications Truncal vagotomy and highly selective vagotomy Laparoscopy for perforated duodenal ulcer Instruments Preparation Technique Problems and solutions Laparoscopic splenectomy Indications Instruments Preparation Technique Problems and solutions Laparoscopic colorectal surgery Indications for laparoscopic colorectal surgery Contraindications Instruments Preparation Technique Problems and solutions Complications Laparoscopy for undescended testis Indications Instruments Preparation Technique Problems and solutions Varicocele Instruments Preparation Technique Problems and solutions Laparoscopic simple nephrectomy Indications Instruments Preparation Technique for transperitoneal nephrectomy Problems and solutions Technique for retroperitoneal nephrectomy Problems and solutions of retroperitoneal approach