Basic Laparoscopic Surgical Techniques

  • Jeffrey W. Milsom
  • Bartholomäus Böhm

Abstract

The ability to suture in laparoscopic colorectal surgery is necessary less frequently than in conventional surgery, yet this ability is essential in certain critical situations, such as securing vascular pedicles, ensuring hemostasis, providing tissue support, maintaining tissue closure, and in creating certain surgical anastomoses. Although the principles of suturing and tying knots in endoscopic surgery are identical to those in conventional surgery, major modifications in technique are necessary as a result of the following:
  • The lack of direct manual contact, for which palpation with current laparoscopic instruments cannot completely compensate.

  • The limited movement of current instruments that are inserted through a cannula anchored to the abdominal wall. The working field is a cone with a fixed point at the insertion point of the cannula. Because of the limited field of movement of laparoscopic instruments, proper placement of the cannula is critical.

  • The lack of normal binocular vision without true depth perception, which makes conventional techniques difficult to apply.

Keywords

Suture Material Conventional Surgery Laparoscopic Colorectal Surgery Monofilament Suture Needle Holder 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 1996

Authors and Affiliations

  • Jeffrey W. Milsom
    • 1
  • Bartholomäus Böhm
    • 2
  1. 1.Section of Colorectal Surgery Research, Department of Colorectal SurgeryThe Cleveland Clinic FoundationClevelandUSA
  2. 2.Universitätsklinik und Poliklinik für ChirurgieUniversitätsklinikums CharitéBerlinGermany

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