Basic Principles of Laparoscopic Surgery - Part 1

Basic Training in Laparoscopic Surgery

Basic Training in Laparoscopic Surgery includes:-

• Understanding the fundamental principles of laparoscopy
• Mastering the art of Instrumentation
• Hands on Training
• Supervised practice on humans (Most important)
• To know one’s role as a Team work(Very important)

Fundamental principles of laparoscopy:-

Pneumoperitoneum is created using a distention medium like Carbon dioxide with the help of an Insufflator machine.

Since carbon dioxide is soluble in blood a capnograph is a must in monitoring the patient during anesthesia for laparoscopic surgeries.

Safe method of insufflation is by using a spring loaded Veress needle.

Insufflation is completed by the introduction of Primary Trocar and the Telescope. This is called the camera port.

The telescope is in turn connected to a light source, fiber optic cable and to a video monitor.

Other ancillary instruments like forceps, scissors, electro cautery, needle holder, clip applicator, suction irrigation device etc are also used. Almost all instruments used in open surgery are now available for laparoscopic surgery.

These instruments are introduced through different ports. The positions of primary port and the accessory ports are determined by the principles of Ergonomics for laparoscopic surgery. (Ergonomics means the norms of work)

Hands on training is a must for the proper hand eye coordination. Good coordination between right and left hands are also needed for laparoscopic procedures.

Supervised practice on humans is another important aspect of training. Each member of the team should know his or her role  for a particular procedure.