After precleaning a flexible endoscope it must be what?
Leak tested
What type of scope do we use to access regional anatomy and obtain biopsy
Flexible endoscope
Why aren't patients who have received previous abdominal surgery goo candidates for laposcopic surgery
High risk of abdominal adhesions
What type of material is used to loosen ligatures for bile ducts during procedure?
Right angle clamps, ultrasonic scalpel, ESU, vessel loops, surgical clips, and HF vessel-sealing system [e.g., Ligasure]
Who is responsible for monitoring fluid pressure going in and coming out of the surgical wound?
Both the surgeon and the circulating nurse monitor fluids.
When looking for things that cause capicitive coupling what area of the instrument do you looking at?
The surface of the telescope, the lens system, couplings, and shaft.
What is the appropiate way to carry a telescope?
Hold the telescope by its (heavier) end, never by the tip or shaft.
The clarity of the image that camera provides depends on what?
The number of pixels (signals) or silicon.
endocoupler
a device that connects the endoscope to the camera. fiber optic cord- cable composed of many thousand of glass or plastic fibers aligned in parallel longitudinal bundles, which are and easily broken by sharp impact or overflexing of the cable.
fiberoptic cord
transmits light from the light source to the camera head or telescope.
camera
receives visual data from the telescope and allows surgeon to view structures without looking directly into the telescope .
What happens to visual field when camera is a different temperature from temperature of the body?
Creates fogging on telescope lens.
What is the approximate end of a flexible endoscope is called?
The control head
insufflation
In minimally invasive surgery, inflation of the abdominal or thoracic cavity with carbon dioxide gas.
trocar cannular system
Is used to create ports or channels through the body wall for insertion of MIS instruments.
stereoscope
In robotic surgery, the binocular lens system of the surgeon's console; provides three dimensional images of the surgical site
What position is the patient placed in for a laproscopic cholecystectomy?
Supine position
What position is the patient placed in for a laparoscopic appendectomy?
Trendelenburg position
What position is the patient place in for a mediastinoscopy?
Supine position
What laparoscopic procedure is performed in the lithotomy position?
Laparoscopic-assisted vaginal hysterectomy
What is the difference between a minimal invasive procedure and an open procedure?
Open surgery typically requires longer healing time because of increased tissue trauma involved in entering the site. Laparoscopic procedures produce smaller incisions therefore reducing both healing and hospital time.
sequential compression device
Appliance used to prevent deep vein thrombosis. A sleeve containing air tubes is wrapped around the leg and thigh; During inflation phase, the cuffs push venous blood toward the heart, and during deflation, the vessels refill.
robotic surgery
incorporates the multiple-port system with robotic technology, in which the surgeon operates from a nonsterile console to perform surgery.
What are two modalities used to replace traditional sutures in the wounds?
a. Clips and d. staples
Active electrode monitoring [AEM]
A method of reducing the risk of patient burns during monopolar electrosurgery. These systems stop the electrical current whenever resistance is high anywhere in the circuit.
Arthroscopy
Endoscopic surgery of a joint.
Auxiliary water channel
A channel in the flexible endoscope used to deliver irrigation fluid at the tip.
Biopsy channel
A channel in the flexible endoscope used to deliver irrigation fluid at the tip.
Camera control [CCU]
The main control source for the video camera. The unit captures video signals from the camera head and processes them for display on the image system.
Cannula
In minimally invasive surgery, a cannula is a slender tube inserted through the body wall that is used to receive and stabilizer telescopic instruments.
Capacitative coupling
In minimally invasive surgery, the unintended transmission of electricity from the active electrode to an adjacent conductive pathway, sometimes resulting in a patient burn.
Control head
The proximal section of a flexible endoscope where the controls are located
Diagnostic endoscopy
A diagnostic procedure in which a long flexible, fiberoptic tube is inserted into a body cavity for viewing and diagnosis
Digital output recorder
During video-assisted surgery, digital signals are captured from the video camera and transmitted to an image system. The digital output recorder processes these signals.
Direct coupling
In minimally invasive surgery, the transmission of electricity directly from one conductive path to another, such as from the active electrode to a conductive path to another.
Docking
In robotic surgery, the process of positioning the robotic instruments in the exact location over the patient so that instruments can be safely attached to their ports in the body cavity.
Elevator channel
A channel that extends the full length of a flexible endoscope and receives biopsy forceps or other instruments.
Extracorporeal
outside the body" In MIS, it refers to a technique for placing sutures in which the knots are formed outside the body and then tightened after they have been introduced into the surgical wound.
Gain
In electronics, the intensity of the signal
Haptic feedback
Tactile feedback, conveyed from tissue to the hand when a hand instrument is used. Robotic instruments do not provide any tactile feedback.
High definition [HD]
A type of video format. The clarity of the image is based on the number of signals [pixels] emitted by the camera. HD format has a 16:9 aspect ratio, which is 7 times greater than standard definition.
Imaging system
The combined components of the endoscopic system, which create the image captured in the focal view of the endoscope.
Insertion tube
The long, narrow portion of the flexible endoscope that is inserted into body.
Instrument channel
A channel that extends the full length of a flexible endoscopic system, which create the image captured in the focal view of the endoscope.
Intracorporeal
inside the body." In minimally invasive surgery, it refers to a suture technique in which sutures are knotted and secured inside the patient.
Intravasation
The unintended absorption of irrigation fluids into the body.
Knot pusher
A device used to secure suture knots during minimally invasive surgery.
Ligation loop
A commercially prepared suture loop used to secure structures during minimally invasive surgery.
Light cable
The fiberoptic light cable that transmits light from the source to the endoscopic instruments; sometimes called a light guide.
Light source
A device that controls and emits light for endoscopic procedures.
Master controllers
In robotic surgery, the nonsterile hand controls that manipulate surgical instruments.
Optical angle
The angle at which light is transmitted at the distal end of a fiberoptic or video endoscope.
Pixel
An element in each silicon chip contained within a device that produces electronic images such as those seen on a surgical image system used in minimally invasive surgery.
Pneumoperitoneum
An abdomen insufflated or distended with carbon dioxide gas during laparoscopy.
Resectoscope
A surgical endoscope that has the capability of morcellation, or tissue fragmentation
Robot
A mechanical device that can be programmed to perform tasks.
Standard definition [SD]
A type of video format. The clarity of an images is based on the number of signals (pixels) emitted for the camera. standard definition format displays 640 x 480 pixels in a rectangular image.
Stereoscopic viewer
In robotic surgery, the binocular lens system of the surgeon console.
Telesurgery
A type of robotic surgery in which surgery is performed from a nearby location through computer-mediated instruments. In telesurgery, no direct physical contact with the instruments occurs.
Veress needle
spring-loaded needle used to deliver carbon dioxide gas during insufflation
Video cable
In video assisted endoscopy, the cable that transmits digital data from the camera head to the camera control unit and from the image system to the output recorder.
Video printer
A device that stores and prints output data viewed through the video endoscope.
White balance
A procedure for adjusting the light color of the through the video endoscope.
Insufflator
Control console for delivering the correct amount, temperature, and pressure of carbon dioxide?
Trocar
A solid rod with a tapered or sharp end that fits inside the hollow tube cannular insufflator-- object used to insufflate.
What function do the cannulas perform?
The cannulas protect the body wall and also maintain a seal between the inside of the body and the outside environment.
telescope
An optical instrument for magnifying the apparent size of distant objects. It consists, in principle, of two lenses: (1) the objective, being a positive lens which forms a real inverted image of the distant object; (2) the eyepiece through which the obser
endoscope
A medical instrument for viewing the interior of the body: a medical instrument consisting of a long tube inserted into the body.
Why are patients who have undergone previous abdominal procedures not good candidates for minimally invasive surgery?
Patients who have undergone previous abdominal procedures have a high risk of abdominal adhesions [scarring of organs that causes adherence to the peritoneal wall]. This presents a risk of perforation as the trocar and cannula are advanced through the bod
Why should you avoid striking the cable on a hard surface?
This can cause the fiberoptic bundles to fracture.
Why must cameras be white-balanced before each procedure?
This is a procedure to adjust the light color to the other components in the system.
Why is irrigation used throughout the endoscopic procedure?
To dilate the operating field and to wash away debris and blood.
When is endoscopic stapling commonly used?
In laparoscopic surgery.
Why is carbon dioxide gas warmed before insufflation?
This maintains the patient's core temperature and prevents fogging of the telescope lens.
What steps are taken to prevent air embolism?
Before it is attached, the tubing is flushed with CO2 gas to purge any air from the tube and prevent air embolism.
What are some of the risks of filling a body cavity or organ with fluid during surgery?
The risk exists that it will be absorbed into the vascular system; this is called intravasation. Injury is caused when the pressure of the irrigation fluid exceeds a safe level, causing fluid to enter the vascular system, thereby increasing blood pressure
Describe the various methods of tissue expansion.
Insufflation expands the abdominal wall and allows clear viewing of the abdominal viscera; continuous irrigation is used in joint spaces; balloon expansion is used in the tissue planes, such as the peritoneal space and inguinal area.
Describe morcellation.
Large specimens and dense tissue are reduced to small pieces by a process called morcellation. The morcellator reduces tissue to pulp, which can be suctioned from the wound.
In what type of procedures is the tissue shaver commonly used?
Tissue shavers are used in endoscopic nasal and orthopedic procedures.
What are some causes of stray current?
Stray current occurs when stray electrosurgical energy seeks a circuit and jumps to an alternative conductive path [i.e., the break in insulation].
What is the difference between extracorporeal and intracorporeal suture technique?
In the extracorporeal suture technique, the knot is tied outside the body cavity and then pushed into place with a knot pusher. In the intracorporeal technique, the suture is knotted and tightened inside the body with two grasping instruments inserted int
What is the difference between a servo-controlled robot and a nonservo robot?
(A servo robot responds through its sensors, whereas a nonservo robot has no feedback or sensing abilities.)
What is robotic telesurgery?
In telesurgery, instruments are inserted manually or with electronic assistance but are controlled through a remote nonsterile console near the sterile field.
What are the responsibilities of the scrub during endoscopic procedures?
During the procedure, the scrub maintains suction and irrigation devices and helps place biopsy instruments into the endoscope. The scrub also receives specimens as they are withdrawn from the endoscope and properly preserves and documents them.
What does the absence of haptic feedback mean for surgeons being retrained on remote instrument manipulation?
During robotic telesurgery, the surgeon must rely on vision alone while manipulating the hand and foot controllers.
What are some of the procedures performed using robotic-assisted MIS?
Joint replacement procedures, valve repair, lung resection, gastrointestinal resection, removal of tumors, hysterectomy, myomectomy, sacrocolpopexy, prostatectomy, cystectomy, and tumor resection