Basic Surgical Procedures
Dissection, haemostasis, knotting and tissue approximation constitute the essence of surgical practice whether this is open or laparoscopic. With the present technology there are a number of restrictions which impose an extra degree of difficulty in executing these basic surgical skills by the laparoscopic approach. An appreciation of the nature of these problems helps the surgeon to modify or adapt the technique to enable the necessary level of proficiency and speed to be achieved. The important restrictions include problems with depth perception and instrument coordination, interpretation of the endoscopic anatomy which is often magnified by the optic to a varying extent depending on the distance between the end of the telescope and the target field, and restricted instrument mobility imposed by the attachment of the access cannulae to the abdominal wall or the limited internal diameter of the operating endoscope (mediastinoscope or recto-scope). These problems are reviewed in detail in Chap. 13.
KeywordsLaparoscopic Surgery Basic Surgical Procedure Continuous Suture Tissue Plane Needle Passage
Unable to display preview. Download preview PDF.