Out of the box and top tips for challenging laparoscopic procedures

Minimally invasive surgery can be both one of the most rewarding and most frustrating experiences in the life of a surgeon. The most important tip is to do your due diligence and practice performing surgery. The most effective way to reduce mistakes, errors, and frustrations is to practice. It is important to practice what you do in the orientation you will perform the procedure in. In a report by Elarbi et.al., they showed that the skills learned in traditional human trainers did not specifically translate to the skills used in standing laparoscopic surgery. To be efficient in minimally invasive surgery, the surgeon needs to practice the techniques that will be used. Trainers do not need to be expensive. A little ingenuity goes a long way in developing training models.

Equipment Tricks

Camera position: It is important to keep the camera upright during the procedures. Most current cameras have buttons on the top that allow image capture, light adjustment, or many other tasks. These buttons should be pointed at the ceiling at all times. Otherwise, the image on the monitor will be canted or upside down. This will make the surgical procedure much more difficult. It is hard enough to deal with the fulcrum effect of traditional minimally invasive surgery, there is no use adding the challenge of an improper camera angle.

Tower position: The laparoscopic monitor should always be positioned in such a way that the telescope points directly at the monitor the majority of the surgery. This is called forward viewing angle. In this way, left on the monitor directly equates to left on the patient. If the telescope points away from the monitor it is called reverse angle viewing. In this instance, left on the monitor will be right on the patient, and vice versa. This also makes the surgery much more difficult.

Image capture: Image capture devices have become commonplace in MIS. However, they can be quite expensive to purchase integrated image capture systems. Consumer based digital video cameras allow the capture of both video and still images and can be attached to most MIS systems. The surgeon can sterilize plastic “Ziploc” bags and put the remotes in the sterile bags to capture video and still images during the procedure. [...]