laparoscopy
TRANSCRIPT
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LAPAROSCOPY
Samha Ahmed Ibrahim Didi
Fathimath Aleefa
DN – 37th Batch
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Objectives
At the end of this presentation you should be able to understand and explain: -
• What laparoscopy is• A brief history of laparoscopy• How laparoscopy is done• Who needs surgery and what laparoscopic surgery will be
done• Benefits of laparoscopy• Perioperative nursing care for laparoscopy
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LAPAROSCOPY
Laparoscopy is also known as: -
“KEYHOLE SURGERY”
MINIMALLY INVASIVE SURGERY
MINIMAL ACCESS SURGERY
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LAPAROSCOPY• Word origin: Greek
• Lapara - "the soft parts of the body between the rib margins and hips
• Skopein, which means "to see or view or examine."
• Laparoscope - endoscope inserted through an incision in the abdominal wall in order to examine the abdominal organs or to perform minor surgery
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WHAT IS LAPAROSCOPY?• Laparoscopic surgery (minimally invasive surgery) is the
performance of surgical procedures with the assistance of a video camera and several thin instruments.
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HISTORY
• 11th century - Abulkasim, Arab physician, used a speculum illuminated by a set of light reflectors and candles - limited applications because the heat produced by candles and other artificial lights resulted in burns.
• 1901- George Kelling did the first laparoscopy on a dog
• 1911- The first laparoscopy in a human was done by a Swedish physician H. C. Jacobeus.
Hans Christian Jacobaeus
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HOW IT IS DONE?
• Small incisions of up to half an inch are made and plastic tubes called ports are placed through these incisions. A camera and instruments are put into the ports and this allows access to the inside of a patient. The video camera serves as the eyes of the surgeon.
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WHO & WHAT?DIAGNOSIS SURGERY
Diverticulitis Bowel resection
Gastric Obstruction Bypass
Splenic disorders Splenectomy
Gallstone Cholecystectomy
Appendicitis Appendectomy
Hernia Hernia Repair
Perforated Ulcer Closure of Perforation
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BENEFITS OF LAPAROSCOPY
• Shortens hospital stay - Quick recovery times• Less post operative discomfort - smaller incisions = less
pain.• Smaller scars• Less internal scarring - Less Handling of intestines
results in little or no disturbance of normal function.• Quicker return to activities of daily living - Avoidance
of the trauma of abdominal wall injury by the incision.
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Perioperative Nursing Care
Preoperative Phase
• Nursing History• Medical History • Previous surgeries • Medication History• Physical assessment• Clinical manifestations• Laboratory & Diagnostic Studies
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Perioperative Nursing CarePreoperative Phase
– Assess and enquire:• Age• Allergies - to medications, topical agents used to
prepare the skin for surgery, and latex can create significant risks.
• Smoking Habits• Alcohol and drug use• Emotional Status• Family Support• Occupation• Cultural and Spiritual Factors
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Perioperative Nursing CarePreoperative Nursing Diagnosis & Interventions
• Knowledge deficit – Health education
• Anxiety – Reassurance & family involvement in patient care.
• Risk for ineffective airway clearance – Maintain a patent airway and monitor for complications
• Risk for ineffective peripheral tissue perfusion – Check capillary refill, note skin colour and check temperature.
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Perioperative Nursing CareFinal Preparation for surgery
• All personal belongings are identified and secured.
• Jewelry is removed & handed over to relatives.
• Dentures are removed, labeled and placed in a denture cup.
• Give preop medications as per physicians orders
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Perioperative Nursing CarePostoperative Phase
• Maintain a patent airway
• Stabilize vital signs - Presence of artificial airway, O2 saturation, BP , pulse, temperature.
• Provide pain relief
• Recognize & manage complications
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Perioperative Nursing CarePostoperative Phase
• Check LOC - ability to follow command, pupillary response
• Urinary output
• Skin integrity
• Condition of surgical wound
• Presence of IV lines
• Position of patient to ensure safety
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Perioperative Nursing CarePostoperative Nursing Diagnosis & Interventions
• Ineffective airway clearance because of increased secretions due to anesthesia, ineffective cough, pain - maintain adequate, patent airway
• Acute pain – Relieve pain
• Urinary retention – Catheterization
• Risk for infection – Maintain aseptic techniques during wound
dressing.
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Appendectomy
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Cholecystectomy
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Inguinal Hernia Repair
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SUMMARY• Laparoscopy is the performance of surgical procedures using a
video camera and several thin instruments. • To perform laparoscopy, small incisions are made and ports are
placed through these incisions through which camera and instruments allow access to the inside of a patient.
• Laparoscopy is used for surgeries of the abdominopelvic cavity. (appendectomy, cholecystectomy etc.)
• Laparoscopy causes less pain, less discomfort, decreases recovery time and less scarring on the inside and out than an open surgery.
• Perioperative nursing care for laparoscopy includes history, assessment, relieving anxiety, preparation for surgery, pain relief, aseptic techniques etc.