Mayo stand and back table instruments for Abdominal Laparoscopy surgery setup

Clamping & Occluding

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  Laparoscopic Clip Appliers

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  Curved Hemostat

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  Kelly Forceps

Cutting & Dissecting

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  L Hook Cautery

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  #3 Knife Handle

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  Laparoscopic Metz Scissor

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  Straight Mayo Scissor

Grasping & Holding

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  Toothed Forcep

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  Laparoscopic Wave Grasper

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  Laparoscopic Fenestrated Grasper

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  Laparoscopic DeBakey Forceps

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  Laparoscopic Maryland Dissector Grasper

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  Adson Forceps

Misc

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  Laparoscope

Retracting & Exposing

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  Army-Navy Retractor

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  Hasson S Retractor

Suctioning

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  Suction Irrigator

Suturing & Stapling

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  Mayo-Hegar Needle Holder

What to expect during Abdominal Laparoscopy

Abdominal laparoscopy is a minimally invasive surgical procedure that allows a surgeon to examine the organs inside the abdomen with the help of a laparoscope, a thin tube with a camera and light. The procedure is performed through small incisions in the abdomen, which reduces recovery time and scarring compared to traditional open surgery. Abdominal laparoscopy can be used to diagnose and treat a variety of conditions, such as abdominal pain, infertility, and tumors.

Extra Equipment
Camera, light cord, CO2 tubing, suction tubing, Endopouch, bovie, poss. port closure device, poss. Verres needle, trocars, poss. Cholangiogram device, telescopes, poss aspirating needle

Drapes
Four folded towels and laparotomy drape

Step 1: Insertion of Verres Needle
To introduce CO2 into the abdomen, a Verres needle may be introduced into the umbilical incision. A Kelley and two towel clips should be available to insert the Verres needle. After inserting the Verres needle, a syringe of saline may also be needed to confirm correct placement.

Step 2: Placement of Trocars
S retractors or Army-Navys may be used to retract the abdominal wall to insert trocars. Alternatively, the first trocar can be inserted and then attached to the CO2 tubing, achieving pneumoperitoneum. The rest of the trocars will then be placed.

Step 3: Insertion of Laparoscope
The laparoscope will then be inserted into the abdomen for viewing. The surgeon may use a variety of graspers, hook cautery, Maryland, or laparoscopic scissors to dissect any fat or adhesions that may obstruct the view.

Step 4: Surgical Exploration
Once the laparoscope is in place, the doctor will view the contents of the abdomen using their preference of graspers. The surgeon may explore the abdomen and surrounding organs to assess for any pathologies or abnormal findings.

Step 5: Closure of Incisions
After the exploration is complete, the ports will be removed, and the incisions will be closed. A needle driver and an adson pick-up will be needed for suturing, and the straight mayo scissors should be available for cutting sutures.

Tips and tricks
With a laparoscopy, there is a high chance it may turn into a bigger case requiring the surgeon to open the abdomen. This will require more instrument pans. Always try to have a major procedure pan and a bookwalter retractor pan in your room just in case.

The Surgery Sparknotes

1. Insert Verres needle.
2. Place trocars with S retractors or Army-Navys or use pneumoperitoneum method.
3. Insert laparoscope for viewing and use graspers, hook cautery, Maryland, or laparoscopic scissors to dissect fat or adhesions.
4. Explore abdomen and surrounding organs for pathologies or abnormalities.
5. Close incisions with needle driver and adson pick-up for suturing and straight mayo scissors for cutting sutures.