A Guide to Laparoscopic ids lal Aaa WER ES by gisele eeContents Preface, vii Section 1: Introduction Introduction/history, 3 Definition, 4 Advantages of laparoscopy, 4 Disadvantages and limitations of laparoscopy, 5 Contraindications/risk factors, 6 Combined laparoscopy and open surgery, 8 Physiological changes during laparoscopy, 9 Anaesthesia during laparoscopy, 13 Postoperative management, 13 Section 2: Equipment, instruments, basic techniques, problems and solutions Equipment, 17 Problems and solutions with imaging and viewing, 20 Sterilization and maintenance of optics and camera, 22 Instruments and access, 22 Creation of pneumoperitoneum/access, 30 Gasless laparoscopy, 31 Pneumoperitoneum by Veress needle, 32 Problems and solutions of Veress needle and pneumoperitoneum, 36 Primary cannula insertion (1st cannula), 39 Problems and solutions of primary cannulae, 42 Open cannulation (Hasson’s technique), 46 Secondary cannula (working cannula, accessory cannula), 48 Problems and solutions, 51 Retraction, 55 Extraperitoneal laparoscopy, 56 Instrument holder, 60 Exiting from the abdomen, 60 Instruments for dissection, 62 Diathermy/electrocautery, 65 Dissection of tissue, 69 Haemostasis, 71 Suction/irrigation, 72 Laser, 73 High intensity focused ultrasound, 76 High velocity water jet, 78 Hydrodissector, 78 Ligation and suturing, 78 Specimen extraction, 92Section 1 Introduction