Science Medicine Surgery
Fundamentals of Laparoscopic Surgery
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Fundamentals of Laparoscopic Surg... FLS Written Exam Prep # 11- Mobility A
82 terms 22 terms 10 terms
kevinesp91 Preview SummerSB2016 Preview Catrina_Moncur
Practice questions for this set
Learn 1 /7 Study with Learn
Controls gas flow between CO2 source and abdomen
Left box= pressure (preset control)
Middle box= gas flow (preset control)
Choose matching term
1 Insufflator 2 Obturator
3 Aperture 4 Tower
Don't know?
2-10 mm diameter
Laparoscope sizes
30-45 cm in length
Controls gas flow between CO2
source and abdomen
Insufflator
Left box= pressure (preset control)
Middle box= gas flow (preset control)
, Converts wall unit low frequency energy to high frequency to an
Monopolar Circuit
active electrode
-Tissue heats (>60 deg C) > protein denaturation
-Tissue cools & bonds are reformed in haphazard way leading to
Tissue Coagulation (3) coagulation
-When water is evaporated > desiccation > impedance/high
resistance to current> current stops flowing when complete
Tissue heating=(current density)^2
Tissue heating & current density
Current density= current (amp)/area (cm^2)
formula
-Large area of tissue contact=low current density
Monopolar circuit Generator > electrode > grounding pad > generator
1. Cut: heat tissue quickly> water becomes steam > cell explodes
(poor thermal regulation)
-low voltage = minimal lateral thermal damage
3 modes of operation of
2. Coagulation: heat is more widely dispersed, relies on sparking
Monopolar
nearby tissue (no contact w tissue), rapid tissue heating
-Produces superficial eschar (fulgration) with high voltage
3. Blend: mix of coag and cut
Involves active electrode (conductor made of metal) passing a
current through an insulator to a passive electrode (metal device
called capacitor)
-Capacitor can hold 40% of initial power
Capacitive coupling
TWO TYPES:
1. Constant contact with tissue: current will pass through
capacitor without consequence because cant store charge
2. Not in contact with tissue: current will be stored in capacitor
and discharge once it touches tissue
The active electrode touches a metal instrument already
Direct coupling touching other tissue and the energy transfers to the other metal
instrument causing inadvertent injury
Monopolar applied to end of structure that has been ligated and
current spreads though ligated tissue causing excess heating
Narrow circuit reterun past where the ligation happened.
Eg. monopolar charge on appendiceal stump > delayed
perforation
Bipolar sealing devices can seal 7 mm
vessels up to ____ in size
-Sheers have active (top) and passive (bottom) jaws
-top is active uses ultrasonic energy > mechanical energy >
Ultrasonic energy (3)
vibrating jaw
-Vibrates jaw with 50,000 Hz
Steroid medication If taking >20 mg/day >3 weeks may need stress dose steroids
preoperatively
Discontinue at least 3 days before
Warfarin preoperatively
Consult w prescribing physician about periop anticoagulation
Pulmonary and cardiac VERY important to CONTINUE
medication preoperatively
NSAIDs & Aspirin preoperatively No evidence of need to discontinue
Fundamentals of Laparoscopic Surgery
Save
Students also studied
Flashcard sets Study guides
Fundamentals of Laparoscopic Surg... FLS Written Exam Prep # 11- Mobility A
82 terms 22 terms 10 terms
kevinesp91 Preview SummerSB2016 Preview Catrina_Moncur
Practice questions for this set
Learn 1 /7 Study with Learn
Controls gas flow between CO2 source and abdomen
Left box= pressure (preset control)
Middle box= gas flow (preset control)
Choose matching term
1 Insufflator 2 Obturator
3 Aperture 4 Tower
Don't know?
2-10 mm diameter
Laparoscope sizes
30-45 cm in length
Controls gas flow between CO2
source and abdomen
Insufflator
Left box= pressure (preset control)
Middle box= gas flow (preset control)
, Converts wall unit low frequency energy to high frequency to an
Monopolar Circuit
active electrode
-Tissue heats (>60 deg C) > protein denaturation
-Tissue cools & bonds are reformed in haphazard way leading to
Tissue Coagulation (3) coagulation
-When water is evaporated > desiccation > impedance/high
resistance to current> current stops flowing when complete
Tissue heating=(current density)^2
Tissue heating & current density
Current density= current (amp)/area (cm^2)
formula
-Large area of tissue contact=low current density
Monopolar circuit Generator > electrode > grounding pad > generator
1. Cut: heat tissue quickly> water becomes steam > cell explodes
(poor thermal regulation)
-low voltage = minimal lateral thermal damage
3 modes of operation of
2. Coagulation: heat is more widely dispersed, relies on sparking
Monopolar
nearby tissue (no contact w tissue), rapid tissue heating
-Produces superficial eschar (fulgration) with high voltage
3. Blend: mix of coag and cut
Involves active electrode (conductor made of metal) passing a
current through an insulator to a passive electrode (metal device
called capacitor)
-Capacitor can hold 40% of initial power
Capacitive coupling
TWO TYPES:
1. Constant contact with tissue: current will pass through
capacitor without consequence because cant store charge
2. Not in contact with tissue: current will be stored in capacitor
and discharge once it touches tissue
The active electrode touches a metal instrument already
Direct coupling touching other tissue and the energy transfers to the other metal
instrument causing inadvertent injury
Monopolar applied to end of structure that has been ligated and
current spreads though ligated tissue causing excess heating
Narrow circuit reterun past where the ligation happened.
Eg. monopolar charge on appendiceal stump > delayed
perforation
Bipolar sealing devices can seal 7 mm
vessels up to ____ in size
-Sheers have active (top) and passive (bottom) jaws
-top is active uses ultrasonic energy > mechanical energy >
Ultrasonic energy (3)
vibrating jaw
-Vibrates jaw with 50,000 Hz
Steroid medication If taking >20 mg/day >3 weeks may need stress dose steroids
preoperatively
Discontinue at least 3 days before
Warfarin preoperatively
Consult w prescribing physician about periop anticoagulation
Pulmonary and cardiac VERY important to CONTINUE
medication preoperatively
NSAIDs & Aspirin preoperatively No evidence of need to discontinue
