Laparoscopic instruments

This would be help to used laparoscopic instruments in every surgical procedures.

1. LAPAROSCOPIC INSTRUMENTS Presented By: Lecturer and program Coordinator’s of Surgical Technology, DIMT, DUHS.

2. LAPAROSCOPY Laparoscopy is a technologically dependent surgery comprising of computerized designed instruments with microprocessor controlled safety features.

3. LAPAROSCOPIC SURGERY laparoscopy also called minimal invasive surgery or keyhole surgery. laparoscopy is an operation performed in the abdomen or pelvis using small incisions (usually 0.5–1.5 cm) with the aid of a camera.

4. Laparoscopic Surgical Instruments Usually consist of following: Cannulas and Trocars. Trocar Incision Closure Devices. Electrodes and Electrosurgical Cables. Laparoscopic Bipolar Scissors and Graspers. Forceps and Graspers. Hooks and Probes. Knot Pushers. Needles and Needle Holders.

5. LAPAROSCOPIC INSTRUMENTS Optical devices Equipment's of creating/ maintaining domain Instruments for Access Operative instruments Energy sources Hemostatis Miscellaneous

6. 1:OPTICAL DEVICES TELESCOPE: A telescope is like a thin laprascope with a light source. It is used to light up and magnify the structures of the abdominal cavity. A telescope is passed/ insert into the abdomen through a small cut in the skin.

7. Flow chart of laparscopic equipments

8. LIGHT SOURCE Halogen bulbs are low voltage and have an average life of 2,000 hours. Colour temperature of Halogen lamp is (5000-5600 K). These lamps are cheap and can be used for laparoscopic surgery if low budget setup is required.

9. LIGHT CABLES Now a day there is two types of light cable available in field . Fiber Optic cable liquid crystal gel cable

10. Function of light cable Optic cables : T hese cables are made up of a bundle of optical fib res glass thread swaged at both ends. The fiber size used is usually between 10 to 25 mm in diameter. They have a very high quality of optical transmission, but are fragile. Gel cables : These cables are made up of a sheath that is filled with a clear optical gel. (Liquid crystal). Theoretically they are capable of transmitting 30% more light than optic fiber .

11. Television monitor The basic principle of image reproduction is horizontal beam scanning on the face of the picture tube. This plate is coated internally with a fluorescent substance containing phosphor. This generates electrons when struck by beams from the electron gun. As the beam sweeps horizontally and back it covers all the picture elements before reaching its original position.

12. 2 :Equipment's Gas insufflation ca2: Laparoscopic surgery involves insufflation of a gas (usually carbon dioxide) into the peritoneal cavity producing a pneumoperitoneum . This causes an increase in intra-abdominal pressure (IAP). Carbon dioxide is insufflated into the peritoneal cavity at a rate of 4–6 litre min−1 to a pressure of 10–20 mm Hg.

13. 4 : Instruments for Access 1: VERESS NEEDLE :- A Veress needle or Veres needle is a spring-loaded needle used to create pneumoperitoneum for laparoscopic surgery Of the three general approaches to laparoscopic access

14. Hasson’s cannula A l aparoscopic instrument for open (rather than blind needle insufflation) placement of the initial port. The Hasson has a blunt-tipped obturator instead of a sharp trocar and a balloon on the distal portion of the sheath to hold it in place. Synonym(s): laparoscopic cannula.

15. Optical trocar Optical trocar access is a technique to place the initial trocar in. laparoscopic surgery. With optical trocar access, each tissue layer can be visualized before insertion, which can help prevent organ injury, and air leaks at the trocar site can be minimized even in obese patients.

16. 5 :Operative instruments Trocars:- A trocar is a medical or veterinary device that is made up of an awl, a cannula, and a seal. Trocars are placed through the abdomen during laparoscopic surgery. The trocar functions as a portal for the subsequent placement of other instruments, such as graspers, scissors, staplers, etc

17. Laparoscopic Needle Drivers Needle drivers, or needle holders, are used to grasp and manipulate needles to enable free-hand suturing of wounds or surgical incisions within the body during laparoscopic procedures. Surgical needle drivers have been in widespread use for little over a century.

18. laparoscopic bowel Graspers Laparoscopic bowel graspers, otherwise known as bowel forceps, are a form of grasping instrument designed to safely manipulate delicate abdominal tissue during laparoscopic procedures . Function : One of their main functions is to facilitate adequate access to the surgical site by holding bowel tissue clear of the operating field.

19. Bullet nose grasper Bullet Nose Grasper with either straight or diamond-cut serrations has a blunt bullet nose tip design with an atraumatic grasping jaw (one that will not produce tissue damage . Function : These graspers are ideal for dissecting or grasping delicate anatomy .

20. Dorsey intestinal fenestrated grasper Laparoscopic fenestrated graspers, otherwise known as bowel forceps, are a form of grasping instrument designed to safely manipulate delicate abdominal tissue and intestinal during laparoscopic procedures. FUNCTION:~ their main functions is to facilitate adequate access to the surgical site by holding bowel tissue clear of the operating field.

21. Atraumatic grasper Atraumatic and retraction laparoscopic graspers used in basic, advanced laparoscopy, gyn laparoscopy, and laparoscopic bariatric procedures. Single- and double-action jaws. Available in a modular three-piece design for effective cleaning and inspection or in a traditional design with flush ports for cleaning.

22. Clip applicators : la paroscopic clip applier. An instrument for applying surgical clips to tissue during laparoscopic or endoscopic procedures. Clip applicator is used for applying titanium clip. Titanium clip is used in laparoscopic to stop bleeding and to close small tubular structure.

23. LAPAROSCOPIC STAPLERS Laparoscopic staplers are longer, thinner, and may be articulated to allow for access from a restricted number of trocar ports. Some staplers incorporate a knife, to complete excision and anastomosis in a single operation. Staplers are used to close both internal and skin wounds.

24. 6 : Dissectors MARYLAND DISSECTOR : The Endo-Maryland Dissector is a mono-polar electrosurgical instrument for dissection and haemo -stasis. Branches for coagulation and blunt dissection of tissue. Reverse handle for best ergonomic performance and higher force for blunt dissection.

25. BIPOLAR DISSECTOR : The bipolar forceps securely grasp tissue, precisely dissect, and are able to effectively coagulate small as well as very large blood vessels (2 mm to 20 mm), alleviating the need for surgical clips or staples.

26. 7 : Scissors laparoscopic surgery, scissors are used to cut a variety of tissue, including fibrotic or calcified tissue, sutures, and occasionally tissue containing staples. Disposable scissors may become dull and ineffective.

27. Hook scissor : Surgical hooks are common surgical instruments, found in most instrument sets and used for exploration and the manipulation and retraction of tissues, nerves, vessels, and bone. Styles include hook scissors, dural hooks, manipulators, nerve hooks, blunt or ball-tipped hooks, bone hooks, guide hooks, and more.

28. 8.Clamps : Endo lung clamp: The endo lung instrument has application in a variety of general, thoracic, gynecologic, urologic and endoscopic procedures for temporary grasping/clamping of tissue and small tubular structures.

29. ENDO BABCOCK CLAMP Endo Babcock™ Single Use Instrument The Endo Babcock™ 10 mm instrument has applications in a variety of general, thoracic, gynecologic, urologic, and endoscopic procedures for temporary grasping/clamping of tissue and small tubular structures.

30. 9 :Energy sources Electrosurgery : Electrosurgery is the application of a high-frequency alternating polarity, electrical current to biological tissue as a means to cut, coagulate, desiccate, or fulgurate tissue. Its benefits include the ability to make precise cuts with limited blood loss.

31. References ttps://www.surgicalholdings.co.uk/laparoscopic-instruments.html https://www.laparoscopic.md/surgery/instruments https://www.aesculapusa.com/content/dam/aesculap-us/us/website/aesculap-inc/healthcareprofessionals/or-soultions/pdfs/DOC960-Laparoscopic-Instruments-Overview-Brochure.pdf