Laparoscopy

Laparoscopy

1. P RE S E N T E D B Y MR. ROMAN BAJRANG RE LI A N C E IN ST I T U T E O F NURSING LAPAROSCOPY

2. INTRODUCTION

3. DEFINITION DEFINITION “ Laparoscopy is a type of surgical procedure that allows a surgeon to access the inside of the abdomen (tummy) and pelvis without having to make large incisions in the skin. This procedure is also known as keyhole surgery or minimally invasive surgery. ACCORDING TO BR UNER & SHIDDHARTH

4. TYPES:- Intraperitoneal Extraperitoneal Abd wall retraction (glasses laproscopy ) Hand assisted ( H assans tech )

5. LAPAROSCOPY

6. HISTORY 1910 - Swedish physician Hans Christian Jacobaeus used this procedure in man and coined the term – LAPAROSCOPY . 1987 - Mourett in France successfully removed a diseased gall bladder laparoscopically .

7. INDICATION Acute pelvic conditions Tubal pregnancy Ovarian diseases Infertility Staging of the malignancy Biopsy from the tumors In chronic pain abdomen where ultrasound, endoscopies, barium studies are negative

8. advantages:-

9. ARTICLE REQIRED Zero degree laparoscopy Cold light source (Halogen and Xenon lamp) Camera ( 3chip camera commonly used with high resolution Video monitor to display images CO2 insuffuser Long fine dissectors Hooks and spatulas with cautery for dissections Clip applicators Needle holders Veress needle Trocars of different sizes - 10mm, 5mm Suction irrigation apparatus Reducers to negotiate smaller instruments through larger ports

10. ZERO DEGREE LAPAROSCOPY

11. COLD LIGHT SOURCE

12. CAMERA

13. NEEDLE HOLDERS

14. VERESS NEEDLE

15. SUCTION IRRIGATION APPARATUS

16. VIDEO MONITOR TO DISPLAY IMAGES

17. CO2 INSUFFUSER

18. LONG FINE DISSECTORS

19. CLIP APPLICATORS

20. TROCARS OF DIFFERENT SIZES

21. SUCTION IRRIGATION APPARATUS

22. Laparoscopy is usually done as an outpatient procedure. This means that you’ll be able to go home the same day as your surgery. It may be performed in a hospital or an outpatient surgical center . You’ll likely be given general anesthesia for this type of surgery. This means that you’ll sleep through the procedure and won’t feel any pain. To achieve general anesthesia, an intravenous (IV) line is inserted in one of your veins. Through the IV, your anesthesiologist can give you special medications and well as provide hydration with fluids . In some cases, local anesthesia is used instead. A local anesthetic numbs the area, so even though you’ll be awake during the surgery, you won’t feel any pain . During laparoscopy, the surgeon makes an incision below your belly button, and then inserts a small tube called a cannula . The cannula is used to inflate your abdomen with carbon dioxide gas. This gas allows your doctor to see your abdominal organs more clearly . Once your abdomen is inflated, the surgeon inserts the laparoscope through the incision. The camera attached to the laparoscope displays the images on a screen, allowing your organs to be viewed in real time . PROCEDURE-

23. 6. The number and size of incisions depends upon what specific diseases your surgeon is attempting to confirm or rule out. Generally, you get from one to four incisions that are each between 1 and 2 centimeters in length. These incisions allow other instruments to be inserted. For example, your surgeon may need to use another surgical tool to perform a biopsy. During a biopsy, they take a small sample of tissue from an organ to be evaluated. 7 . After the procedure is done, the instruments are removed. Your incisions are then closed with stitches or surgical tape. Bandages may be placed over the incisions.

24. COMMONLY PRACTICED LAPAROSCOPIC SURGERIES Commonly practiced laparoscopic surgeries . Laparocopic cholecystectomy Laparoscopic appendicectomy Laparoscopic inguinal hernia repair Laparoscopic hysterectomy

25. LESS COMMONLY PRACTICED LAPAROSCOPIC SURGERIES :- Laparoscopic perforation repair Laparoscopic splenectomy Laparoscopic vagotomy and Gastrojejunostomy Laparoscopic urologic surgeries

26. GENERAL INSTRUCTION Avoid driving a vehicle during the first 48 hours after the laparoscopic surgery as he may feel drowsy effects of the anesthesia . Take rest during the day after surgery . After 24 hours he can do his normal works as long as he is not on any of the narcotic medications . Not take bath or shower within the first 48 hours after the surgery . Don't do cycling Jogging or sexual intercourse.

27. Not go for a swim in the ocean or in a swimming pool during the first two days of the surgery . Not get into a hot tub or Jacuzzi@ at least for 2 weeks after the laparoscopy surgery . Drink as much fluids as possible to prevent dehydration. Not eat hard foods and stay to the light liquids, like apple juice, ginger ale, soup, toast etc to prevent stomach upsets immediately after the surgery . Get back to the normal diet after two to three days when the patient feels alright . Drink more water to prevent constipation caused by pain medications.

28. AFTER CARE :- Maintain hygine and compostable place provided. Maintain medication provid to the night time and wight patient. Mountain died instuard the good and healthy clief indure the padsend . Health education.

29. COMPLICATION vascwall insully Bowed | Bladder gnJuly abdominal wall Harmanwhoge Bleeding fuom salid augan Copembolism Hypeu Caubig Subcutaneous Emphysema Proumayhallart 1 Premomelistenum Respiratory exidosis Acute kidney injury Postoperative shoulder Pain Newologie injury

30. CONCLUSION Laproscopy is now the " gold standard For operative treatment of most abdominal surgery disease . Lapuoscopy has sevolutionised sunguy and in the process influenced the Practice of anaesthesi - ology . With Patient prepaidation of no pain And early dischange anesthetic choices become vital for the ultimate success off the procedure.