Basic Principles of Laparoscopic Surgery-Part 2
Laparoscopic surgery is an instrument based surgery. The success of a laparoscopic procedure depends on the skill of the surgeon and the combined efforts of his surgical team.
Co axial / straight line principle of Laparoscopy:
The surgeon, the target organ of pathology and the monitor must be in a straight line.
Base Ball Diamond Court Concept of Laparoscopy:
Right Port Left Port
Centre Port
Pathology
Baseball Diamond Court Concept is important in the triangulation of the instruments. If this principle is followed the clashing between the instruments can be prevented.
Manipulation Angle is the angle between two working ports. Ideal manipulation angle is 60º.
Azimuth Angle is the angle between one instrument and the optical axis of the endoscope. Ideal azimuth angle is equal for the active and assisting instruments.
Elevation Angle is the angle between the instrument and the horizontal plane. Ideal elevation angle is 60º.
These three angles determine the optimal port placement.
