Laparoscopic equipment and instrumentation in 2017
Epublication WebSurg.com, Nov 2017;17(11). URL: http://websurg.com/doi/lt03en12524
This two-part presentation outlines the principles and methods of functioning of the main medico-technical devices required to perform laparoscopic surgery. The first part deals with the laparoscopic unit components including the insufflator, light sources, the evolution of cameras and screens, as well as scopes used in laparoscopic surgery. For each component, operating principles, technological developments, malfunctions and their management are discussed. The second part presents operating modalities based on novel innovative energy technologies which are used to control tissues. Their operating modalities, specific risks and prevention means are envisaged. This relates in the first place to the evolution of the use of high frequency currents delivering monopolar and bipolar currents within tissues. New ways of management of these currents with tissue vessel-sealing processes are also discussed. Finally, the principles, use and risks of the new means of dissection and tissue sealing with ultrasonic devices are addressed. The operating principles and the specific risks of all these systems are not well known to surgeons. In case they are not correctly used, they represent new risks and surgeons should be aware of it. In conclusion, ergonomic choices of conventional instrumentation in minimally invasive surgery are outlined.