What Does Laparoscopic Cholecystectomy Look Like?

① Make pneumoperitoneum. An arc incision is made along the lower margin of the umbilical fossa, about 10mm long. If the lower abdomen has been operated on, the skin can be cut on the upper margin of the umbilical fossa to avoid the scar of the original operation.

The surgeon and the first assistant each hold cloth forceps to lift the abdominal wall from both sides of the umbilical fossa. The surgeon holds the pneumoperitoneum needle (Veress needle) with the right thumb and index finger, and the wrist is forced to stab the abdomen vertically or slightly obliquely to the pelvic cavity.

During the process of puncture, the needle penetrated the fascia and peritoneum twice. Determine if the tip has entered the abdominal cavity. Can be connected to take out the syringe with normal saline, when the needle tip in the abdominal cavity when negative pressure. Connect the pneumoperitoneum machine. If the inflation pressure does not exceed 1.73kPa, the pneumoperitoneum needle is in the abdominal cavity. Do not inflate too fast at the beginning, use low flow inflation, 1 ~ 2L per minute.

At the same time, observe the intraperitoneal pressure of pneumoperitoneum machine, the pressure should not exceed 1.73kPa when inflating, too high indicates that the position of pneumoperitoneum needle is not correct, or the anesthesia is too shallow and the muscle is not slack enough, so appropriate adjustment should be made. When the abdomen began to rise and the liver flap boundary disappeared, it could be changed to high-flow automatic inflation until the preset value (1.73-2.00 kPa) was reached. At this time, the patient's abdomen was completely raised by inflating 3-4 L, and the operation could be started.

The abdominal wall was lifted with towel forceps at the pneumoperitoneum needle of the umbilical cord and punctured with a 10mm trocar. The first puncture is a dangerous step in laparoscopy with certain "blindness", so extra care should be taken. The trocar is rotated slowly and evenly into the needle. When it enters the abdominal cavity, there is a sudden feeling that the resistance disappears. When the closed air valve is opened, gas escapes. A pneumoperitoneum machine was connected to maintain constant pressure in the abdominal cavity. Then the laparoscope is put in, and the puncture of each point is carried out under the supervision of the laparoscope.

Generally, the puncture was performed 2cm below the xiphoid process, and a 10mm cannula was put in to prepare the discharge hook, clamp and other instruments. 2cm below the costal margin of the right midclavicle line or 2cm below the costal margin of the rectus abdominis and the anterior axillary line, each was punctured with a 5mm trocar to place the irrigator and gallbladder fixation grasp forceps. At this time, artificial pneumoperitoneum and preparation work have been completed.

Because pneumoperitoneum and the first trocar puncture can injure the large blood vessels and intestines in the abdominal cavity by mistake, and it is not easy to find during the operation. Recently, many people make a small incision in the umbilical cord, find the peritoneum, and put the trocar directly into the abdominal cavity to inflate. After pneumoperitoneum was successfully manufactured, surgical procedures were initiated.

If you have any questions, please contact us. Our company can produce various customized needles, medical needles, puncture needles, hypodermic needles, biopsy needles, vaccine needles, injection needles, syringe needles, veterinary needles, pencil point needle, ovum pick up needles, spinal needles, etc. If you need customized needle products, please contact us. We look forward to your inquiry! The quality of the products manufactured in our factory will surely satisfy you!

Please contact us if you need: zhang@sz-manners.com