How is laparoscopy done

The following are the basic steps of laparoscopic operation. 1. An artificial pneumoperitoneum is incised into the skin 1cm from the lower edge of the umbilical chakra, and a pneumoperitoneum needle is inserted at 45 degrees from the incision. After the blood is removed, a needle tube is connected. If the normal saline flows in smoothly, the puncture is successful and the needle is in the abdominal cavity. Connect the CO2 inflator, the air intake speed should not exceed 1L/min, and the total amount should be 2-3L. The intra-abdominal pressure does not exceed 2.13KPa (16mmHg). 2. In laparoscopic trocar puncture, the trocar needs to be inserted into the abdominal cavity from the cannula, so the trocar needs to be pierced first. Refer to the abdominal puncture section of this chapter for the method. The laparoscopic sleeve is thicker and the incision should be 1.5cm. Lift the abdominal wall below the umbilical cord, insert the trocar slowly and then obliquely into the abdominal cavity. When you enter the abdominal cavity, you feel a sense of breakthrough. Pull out the trocar core and insert the laparoscope after hearing the gas rushing out of the abdominal cavity. Turn on the light source and adjust the patient. Position your head 15 degrees low buttocks high, and continue to inflate slowly. 3. The laparoscopic observation operator holds a laparoscope and observes the uterus and various ligaments, ovaries and fallopian tubes, rectal and uterine depressions with eyepieces. During the observation, the assistant can move the uterine lifter and change the position of the uterus to cooperate with the examination. If necessary, suspicious lesions can be taken for pathological examination. 4. Take out the laparoscope to check that there is no internal bleeding and organ damage, then take out the laparoscope, remove the gas in the abdominal cavity, remove the cannula, suture the abdominal incision, cover it with sterile gauze, and fix it with tape. 5. Post-laparoscopic examination: (1) Antibiotics should be given to prevent infection; (2) Although the abdominal incision has been vented before suturing the abdominal incision, there may still be residual gas in the abdominal cavity causing shoulder pain and upper abdominal discomfort. It is usually not serious and does not need to Special treatment.

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