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Laparoscopy
- 1. LAPAROSCOPY Samha Ahmed IbrahimDidi Fathimath Aleefa DN – 37th Batch
- 2. Objectives At the endof 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
- 3. LAPAROSCOPY Laparoscopy is alsoknown as: - “KEYHOLE SURGERY” MINIMALLY INVASIVE SURGERY MINIMALACCESS SURGERY
- 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 ISDONE? • 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? DIAGNOSISSURGERY 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 PreoperativePhase • Nursing History • Medical History • Previous surgeries • Medication History • Physical assessment • Clinical manifestations • Laboratory & Diagnostic Studies
- 11. Perioperative Nursing Care PreoperativePhase – 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 PreoperativeNursing 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 FinalPreparation 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 PostoperativePhase • 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 PostoperativePhase • 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 PostoperativeNursing 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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- 20. SUMMARY • Laparoscopy isthe 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.