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Laparoscopic Use And Maintenance
Jul 04, 2018

Laparoscopy is used correctly

(1) Anesthesia. Laparoscopic surgery is generally performed on general anesthesia. There are also laparoscopic simulators for epidural anesthesia in hospitals, but the abdominal wall of the patient should be completely relaxed.

(2) Instrument preparation. Install the various instruments so that the laparoscope is in standby. The negative electrode of the electrocoagulator was fixed on the right thigh of the patient, and the laparoscopic instrument was immersed in 2% glutaraldehyde solution for 30 min. After disinfection, it was taken out and placed in another sterile container containing sterile physiological saline. Inject the sterile saline solution into the tube, and remove the residual disinfectant in the lumen when the sinus is taken out. Then, inject the sterile saline solution into the pipeline with a 50 ml sterile empty needle, and rinse the residual disinfectant in the official cavity. The rinsing step after disinfection is very important. Effective rinsing can prevent the chemical solution from leaking into the abdominal cavity and causing chemical burns and postoperative abdominal adhesions. Turn on each instrument and connect it to the laparoscopic instrument on the operating table and connect it to the instrument on the operating table. Check whether the electric knife is normal; adjust to the required size, check whether the pneumoperitoneum is unobstructed, the camera is generally not disinfected, and can be placed on a sterile cloth sleeve or a sterile plastic bag. Prepare 50~80°C sterile water for warming the laparoscopic mirror to prevent condensation due to temperature difference between the abdominal cavity and the lens surface, affecting the field observation. Surgery can begin when everything is ready.

(3) Establish a pneumoperitoneum. In the patient's umbilicus with pneumoperitoneum puncture, the examination proved to be in the abdominal cavity, with CO2 gas as a pneumoperitoneum and the intra-abdominal pressure reached 1.33~2.00KPa (10~15mmHg), then adjusted to automatic pneumoperitoneum.

(4) Place the casing. Place the umbilicus with a 10mm trocar, place the laparoscope to observe and place the camera, and then puncture the other parts through the TV screen. At this time, the operating bed is shaken to the position required for the operation, and the puncture site and posture are different depending on the type of surgery performed. The cholecystectomy is the top of the head and the left side.

(5) Surgical cooperation. During the operation, according to different types of surgery, the instruments used and the procedures performed, the nurse must be familiar with each procedure of the surgeon. After the operation, the small incision is sutured in the cortex, and the surface does not need to be sutured. It can be pasted with a band-aid or a plaster. Properly handle the in-line wires according to the final processing principle, and then turn off the machine one by one.

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