Abdominal Laparoscopy
This is a diagnostic or therapeutic procedure where an endoscope is inserted into the peritoneal cavity to visualize the intra-abdominal organs. It allows for the inspection of the viscera and the performance of minor surgical maneuvers without the need for a large laparotomy incision.
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Practice test
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Surgical instruments
18 on this table. Tap a photo to zoom, the name for its card.
The case
Spark notes
The 30-second rundown. Scan this outside the room.
- Insert Veress needle.
- Place trocars with S retractors or Army-Navys or use pneumoperitoneum method.
- Insert laparoscope for viewing and use graspers, hook cautery, Maryland, or laparoscopic scissors to dissect fat or adhesions.
- Explore abdomen and surrounding organs for pathologies or abnormalities.
- Close incisions with needle driver and adson pick-up for suturing and straight mayo scissors for cutting sutures.
Walkthrough
What the surgeon does, and what to have in your hand before they ask.
Insertion of Veress Needle
To introduce CO2 into the abdomen, a Veress needle may be introduced into the umbilical incision. A Kelly and two towel clips should be available to insert the Veress needle. After inserting the Veress needle, a syringe of saline may also be needed to confirm correct placement.
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.
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.
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.
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.
Lay the CO2 insufflation tubing on the back table with the camera and light cord so all three pass off together, and coil the suction tubing in a basin so it is ready to hand up.
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