Download e-book for iPad: Color Atlas of Laparoscopy by Hiwa Omer Ahmed

By Hiwa Omer Ahmed

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These are very effective at penetrating the abdominal wall by cutting the tissue as they pass through. which allow instruments to move in and out within cannula without the loss of pneumoperitoneum. These valves can be oblique, transverse, or in piston configuration. These valves can be manually or automatically retractable during instrument passage. 56 Most of the disposable plastic trocar has a spring loaded mechanism that withdraws the sharp tip immediately after it passes through the abdominal wall to reduce the incidence of injury of viscera.

A variety of instruments, especially retractors have been developed with multiple articulations along the shaft. When these are fixed with the tightened cable the instrument assumes a rigid shape which could not have been introduced through the cannula. Most of the hand instrument has three detachable parts. 1. Handle, 2. Insulated outer tube and 3. Insert which makes the tip of the instrument. 8 to 12mm but majority of instruments are designed to pass through 5 to 10mm of cannula. The hand instrument used in laparoscopic surgery are of different length (varies company to company and length of laparoscopic instrument varies from 18 to 45cm) but they are ergonomically convenient to work if they have the same length of approximately 36 cm in adult and 28 cm in pediatric practice.

The locking mechanism is usually incorporated into the handle so that surgeon can easily lock or release the jaws. These systems usually have a ratchet so that the jaws can be closed in different position and to different pressure. 64 63 Color Atlas of Laparoscopy Color Atlas of Laparoscopy Chapter II Equipments and Instruments Chapter II Equipments and Instruments Outer Sheath of Hand Instrument The insulation covering of outer sheath of hand instrument should be of good quality in hand instrument to prevent accidental electric burn to bowel or other viscera.

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Color Atlas of Laparoscopy by Hiwa Omer Ahmed

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