Laparoscopy involves using a video camera and thin instruments inserted through small abdominal incisions to perform surgery. It allows internal organs to be viewed and manipulated with less pain and faster recovery compared to open surgery. Common uses include appendectomy, gallbladder removal, and hernia repair. Perioperative nurses provide care before, during, and after laparoscopy by assessing patients, relieving anxiety, maintaining aseptic technique, and ensuring effective airway clearance and pain management.
2. 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
4. 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
5. 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.
6. 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
7. 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.
8. 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
9. 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.
10. Perioperative Nursing Care
Preoperative Phase
• Nursing History
• Medical History
• Previous surgeries
• Medication History
• Physical assessment
• Clinical manifestations
• Laboratory & Diagnostic Studies
11. Perioperative Nursing Care
Preoperative 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
12. Perioperative Nursing Care
Preoperative 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.
13. Perioperative Nursing Care
Final 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
14. Perioperative Nursing Care
Postoperative Phase
• Maintain a patent airway
• Stabilize vital signs - Presence of artificial airway, O2
saturation, BP , pulse, temperature.
• Provide pain relief
• Recognize & manage complications
15. Perioperative Nursing Care
Postoperative 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
16. Perioperative Nursing Care
Postoperative 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.
20. 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.
