Download Advanced Laparoscopic Surgery: Techniques and Tips, Second by Namir Katkhouda PDF

By Namir Katkhouda

This moment version of complicated Laparoscopic surgical procedure, thoughts and Tips represents a finished description of the present laparoscopic innovations. It provides surgeons  with the entire info essential to effectively accomplish laparoscopic surgery.  it's a hands-on guide that is helping the doctor keep away from pitfalls and obtain the mandatory laparoscopic talents fast and successfully. it's a prepared resource of sensible aid whilst trouble-shooting is important. complicated laparoscopic surgical procedure is a wonderful merger of a textbook and atlas for the doctor who desires to expand and refine his laparoscopic strategies.

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Additional resources for Advanced Laparoscopic Surgery: Techniques and Tips, Second Edition

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Hemostatic agents such as Tisseal or Floseal (Baxter Inc, Deerfield, IL) can be used to achieve hemostasis. If the bleeding is due to a major tear in the liver, and hepatic or portal venous branches are involved, and if all possibilities are exhausted, the only recourse is conversion using a mini-laparotomy. This has very rarely been the case in the author’s experience, but it may occur more frequently in cirrhotic patients. There is no need for a large subcostal incision and usually a 5 cm mini-laparotomy will suffice.

A completion cholangiogram is performed. A drain is always inserted adjacent to the choledochotomy to monitor bile leakage. Choledochodu­ odenostomy This procedure is similar to open surgery except that the choledochotomy should be performed transversely. The duodenum is then approximated and incised. Interrupted sutures are placed and knotted intracorporeally to avoid tension that might occur if they were to be knotted extracorporeally. Running sutures are possible if the CBD is very dilated. 3).

The use of monopolar current carries the risk of intraabdominal diffusion and transmission of power to adjacent structures. During application of monopolar current other organs should not be touched and the tip of the electrocautery instrument should be kept under direct vision at all times. This is especially true when using monopolar current in conjunction with scissors with long blades or long noninsulated instruments. The risk of intraabdominal explosion is more theoretical than real and has not occurred in the author’s practice, but the use of nitrous oxide in this setting is not recommended because it supports combustion.

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