The exposure method of laparoscopic surgery is different from that of open surgery. Due to the limitations of techniques, instruments, space, perspective and field of vision, the ideal exposure of the operative field can be achieved only in the close cooperation of the whole team of laparoscopic laparoscopes, anesthesiologists, surgeons, surgical assistants and circuit nurses.
Rationale of field exposure in laparoscopic surgery:
In laparoscopic surgery, the doctor completes the operation under the supervision and guidance of the laparoscope.Due to the magnifying effect of the laparoscope, the picture is clear, and the Angle of view and field of view can be changed by the rotation, advance and retreat of the laparoscope, and real-time exposure can be more fully realized.Therefore, the basic principle of laparoscopic surgical exposure is to use the puncture device to make the laparoscope and surgical instruments more smoothly into the ground and more clearly expose the operative field space.For example, the operative field is fully exposed by means of changing body position and tension traction, and then the target tissues and structures are exposed through surgical techniques.
In laparoscopic surgery, it is often said that the lens holder is the "golden eyes" of the team, and the assistant is the "golden left hand" of the master. Indeed, in the process of surgery, the master expects the assistant to be able to predict in advance and accurately expose the field of vision (especially in the ionizing stage).So, can we get good surgical fields in a controlled way?
No.1 Change the cloth hole
Laparoscopic hole layout is in favor of exposure, operation and mutual influence as the principle.For this reason, the puncture hole in laparoscopic surgery follows the isosceles triangle principle with the focal point as the apex, or the principle of fan-shaped observation hole and operation hole with the focal point as the center. The Angle between the left and right lever should be greater than 60 degrees to facilitate the operation and does not affect the laparoscopic exposure.In some cases, the conventional perforation does not expose the operating field, and the operation hole can be added to reach the area where the perforation would normally be difficult to expose.When the right posterior lobe or S8 segment is removed, a right intercostal puncture hole can be added to reach the right posterior lobe and S8 segment, and this operation is superior to the traditional caudal approach.