Introduction of Minimal Access Surgery

Synonym

•       Key Hole Surgery

•       Endoscopic Surgery

•       Button Hole Surgery

•       Minimally Invasive Surgery

•       Minimal Access Surgery

History

•       1901 - Von Ott - First inspection of abdominal cavity using a speculum and candlelight.

•       1983 - First laparoscopic appendicectomy Semm, a German gynaecologist.

•       1985 - First Lap Chole Erich Muhe a German surgeon.

•       1987 - First laparoscopic repair of inguinal hernia by Ger.

•       1989 - First lap hysterectomy, Reich et al.

•       1993 - First Robotic Laparoscopic surgery (Robotic telesurgery) Dan Stoianovici.

What is laparoscopy?

•       Lapo- Abdomen

•       Copy- See

Most commonly SURGICAL PROCEDURES

•       Cholecystectomy

•       Appendicectomy

•       Hernia repair

•       Hemicolectomy

•         Anterior resection/ APR

•         Sleeve gastrectomy

•         Oesophagectomy

•         Bowel resection

Most commonly GYANECOLOGICAL PROCEDURES

•       Hysterectomy

•       Tubal ligation

•       Myomectomy

•       Adhesiolysis

•       Salpingectomy

•       Lymphadenectomy

•       Presacralneurectomy

•       Wertheim's procedure

BASICS OF LAPAROSCOPY – UNITS

•       Video camera control cable and camera process

•       Video monitor

Camera Control Unit with Camera Head and Monitor the image is then relayed on the monitor.

•       Telescopes

Telescopes -0 degree  /30degree 10mm and 5mm

•       Light source and light guide cable

     Light Cable - The light cable contains optical fibres  in order to transmit the light from light sources to the Abdominal cavity.

•       Insufflator 

To extend existing body cavities to make an endoscopic view on organs.

Reasons to use CO2 instead of other gases ?

•          None inflammable.

•             Inexpensive

•             Rapidly absorbed.

•             Rapidly soluble- reduce chance of  gas embolism

•             Smooth recovery from anaesthesia

•       Electrosurgical unit (diathermy machine)

•       Minimal invasive surgical instruments