laparoscopy

Send This

Download

Comment

Favourite

more

Rating :

Rate It:

Embed :

nedal on Oct 24, 2009 Says :

good work

Post a comment

Post Comment on Twitter Post Comment on SlideWorld

Comments:

Subscribe to follow-up comments

2 Favorites

kkyitharster, favourited this 3 Years ago.

juliocoelho, favourited this 3 Years ago.

First Prev [1] Next Last

Notes

Hide Notes

Slide 1 :

LAPAROSCOPY Dr. Hiwa Omer Ahmed Assistant Professor In General Surgery

Slide 2 :

laparoscopy

Slide 3 :

laparoscopy

Slide 4 :

Benifits Perceived benefitsReduced post operative pain and analgesic requirementReduced operative traumaReduced bleeding Faster recovery, discharge and return to workReduced wound infection, seroma and haematomaReduced chronic wound painLess cardiorespiratory complications

Slide 5 :

Benifits Less ileus from reduced handlingImproved cosmesisReduced contamination of theatre staff (Hepatitis and HIV)Interesting for surgeonsReduced outpatient/social costs

Slide 6 :

Benifits Reduced risk of DVT/PEReduced incisional hernia rateFewer adhesions and less likely to develop obstructionImmunological benefitsBetter visualisation for the surgeon

Slide 7 :

Risks Perceived risks High risk of co-lateral injury eg Common bile duct in lap cholecystectomy Bowel/bladder/vascular injury in hernia surgery Verres needle injuryDiathermy may lead to organ damage eg late cbd strictureIncreased operating time

Slide 8 :

Risks Increased costs due to theatre time and equipmentTumour seedingPoor quality surgery eg cancer resectionLoss of tactile sensationLong learning curveLoss of training opportunity eg appendicitis and inguinal hernia Some surgeons not able to develop skills

Slide 9 :

Operations : Now fully accepted Cholecystectomy ? CBD exploration Fundoplication Splenectomy Nephrectomy Adrenalectomy Diagnostic - eg Ca staging, abdo pain

Slide 10 :

? Appendicectomy? Inguinal, Femoral, Incisional, Paraumbilical Hernia repair? Colectomy ? Gastrectomy? Other gastric surgery eg Obesity surgery

Slide 11 :

Veress needle Veress needle (closed and blind with risks) / cutdown (Hassan, open and ?safer)

Slide 12 :

High risk patients likely to benefit most ElderlyObeseCardiorespiratoryAidsThoracic

Slide 13 :

Gaseous insufflation and Pressures Keep pressure as low as possible to reduce CVS and respiratory effectsAlso reduces post operative pain14mm mercury intraperitoneal10 mm mercury extraperitoneal to avoid surgical emphysemaCO2 most commonly used.

Slide 14 :

Gaseous insufflation and Pressures May cause acidosis with respiratory depression and hypercapniaCardiac output may fall as much as 30% due to reduced venous return Bradycardia most common arrhythmia, Respiratory depression due to splinting of diaphragm Other complications may include Pneumothorax, Emphysema, Air embolus

Slide 15 :

What can you expect? Laparoscopy is direct visualization of the peritoneal cavity The laparoscope is an instrument somewhat like a miniature telescope with a fiber optic system which brings light into the abdomen. It is about as big around as a fountain pen and twice as long.

Slide 16 :

Insuflation technique Carbon dioxide (CO2) is put into the abdomen through a special needle (Veress) that is inserted just below the navel.

Slide 17 :

Prior to Surgery Not to eat or drink anything after 12:00 midnight the night before surgery. Not to smoke or chew gum after 12:00 midnight. Currently taking medication, some should be stopped ..

Slide 18 :

Prior to Surgery Bowel preparation is usually recommended for patients with endometriosis pelvic adhesions pelvic pain.

Slide 19 :

Prior to Surgery Patient must take a shower or bathe the night prior to surgery.. Nail polish, make-up and jewelry should be removed the night before surgery. Wearing loose-fitting clothes to prevent any unnecessary pressure on the abdomen on the day of surgery.

Slide 20 :

Immediately Before Surgery Immediately prior to surgery to empty your bladder Glasses, contact lenses, dentures and jewelry should be removed. Valuables should be left in the safekeeping of the person who accompanies the patient or should be left at home.

Slide 21 :

In the Operating Room

Slide 22 :

In the Operating Room

Slide 23 :

In the Operating Room

Slide 24 :

In the Operating Room

Slide 25 :

In the Operating Room

Slide 26 :

In the Operating Room

Slide 27 :

In the Operating Room

Slide 28 :

In the Operating Room

Slide 29 :

In the Operating Room

Slide 30 :

In the Operating Room

Slide 31 :

After Surgery Early mobilization Checking vital signs: blood pressure, pulse and temperature frequently. Checking the dressing and intravenous. If the patient is cold, an extra blanket given The nurse or physician will tell the patient when he will be allowed to drink something

Slide 32 :

discuss the findings with your patient and his family immediately after the surgical procedure is complete.

Slide 33 :

After Surgery Kept in Surgery Center for approximately three or four hours after the procedure.

Slide 34 :

Medication will be available for pain or nausea.

Slide 35 :

Diet consume only clear liquids (juices, Jello, or both) until the patient pass flatus or have a bowel movement. At this time, may begin to advance the diet. To eat light, easily digested food for a few days.

Slide 36 :

activity To get up and move about, even through may not want to. Increase the activity gradually during this time. For a week or two after surgery expect to tire easily even after the slightest effort of work or exercise. Not to engage in strenuous activity until after the first post-op visit at office.

anesthesia for lapar...

Free Powerpoint Templates

	drhiwaomer 4 Years ago.



8366 Views, 3 favourite
laparoscopic teaching slide show- Slides
More By User Flag as inappropriate Select your reason for flagging this presentation as inappropriate. If needed, use the feedback form to let us know more details. Cancel