After completion of laparoscopy, the linea alba is apposed using #0 or # 1 polyglactin 910 or PDS in an appositional pattern (e.g., cruciate or simple interrupted). Skin edges are apposed using #0 or #1 nylon, polypropylene or stainless steel skin staples.
Operative Laparoscopy
Laparoscopic-guided biopsy of the liver, spleen, and kidneys may be useful for evaluation of these tissues. Laparoscopic examination of reproductive structures is readily accomplished including ovariectomy, cryptochidectomy, and vasectomy. Laparoscopy has also been used successfully to resolve clinical adhesions to the uterus, ovaries, and intestine. Laparoscopic reduction or fenestration has been used to resolve ovarian cysts, endometrial cysts, ovarian neoplasia, and for ovariohysterectomy.
Practice Tip to Facilitate Procedure
With practice, good working equipment, proper patient selection, and preparation, laparoscopy can be rapidly and efficiently performed. The key elements to successful laparoscopy include appropriate equipment and sufficient light source and insufflation. Versatile laparoscopic ports that allow the user to switch between 10- and 5-mm-diameter instruments greatly facilitate procedures when the viewing port and instrument ports need to be changed. Also, ports that have an inflatable cuff on one end allow secure retention of the cannula in the abdominal wall while retaining little length of the cannula within the abdomen (Figures 44.1–44.5). Dual cannulas that serve both as a viewing port and an instrument port provide flexibility when space limitations of the anatomical window limits the number of ports that can be inserted.
Only gold members can continue reading. Log In or Register to continue
