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132 Cards in this Set
- Front
- Back
Minimally Invasive Surgery (MIS) is performed using a ___ lensed telescope and long instruments
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Ridged
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The telescope and long instruments are inserted into ____ incisions at the operative site.
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small
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In the MIS technique, the operative space may be enlarged with fluid or ____ ____.
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carbon dioxide
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The goal of the minimally invasive technique is primarily surgical rather than ____.
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diagnostic
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____ endoscopy and operative endoscopy usually are performed with a flexible, semirigid, or rigid endoscope that is inserted into an anatomical opening in the body.
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Diagnostic endoscopy
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The ____ system, channels for introducing small instruments, and light system are contained in one long tube.
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lens
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Flexible endoscopy is used to assess the regional anatomy, to obtain tissue biopsies, and to perform ____ surgical procedures.
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minor
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The ___ endoscope is used to perform a surgical assessment and operative procedures, such as transurethral resection of the prostate and transcervical resection of a uterine fibroid tumor.
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rigid endoscope
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____ instruments refers to the rigid lensed instruments used in MIS.
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Telescopic instruments
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____ is used to describe the flexible lensed instrument that is passed through a natural orifice for assessment or surgery of a hollow organ, duct, or vessel.
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Endoscope
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Narrow tubes called ____ are inserted into each incision.
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Cannulas
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How long do the cannulas remain in place?
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throughout the entire surgery
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The cannulas ____ the body wall and also maintain a seal between the inside of the body and the outside environment.
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protect
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To perform surgery inside the body, the surgeon inserts a slender optical ___ through one of the cannulas.
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telescope
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Surgery is performed by adjusting the ____ to obtain different views and by manipulating the telescopic instruments as the appear on the monitor
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endoscope
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Advantages to MIS:
-Reduced Tissue Trauma -Less blood loss -Less pain -Faster recovery and return to normal activities -Can be done as out patient surgery in many cases -Reduced postoperative pain -Increased patient satisfaction -Less costly |
NOTE ---->>>>
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Patients who have undergone previous abdominal procedures have a high risk of abdominal ___.
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adhesions (scaring of organs that causes adherence to the peritoneal wall)
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Endoscopic instruments are limited in their ___ of ___.
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range of motion
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In an MIS procedure the operating space is very small, which reduces maneuverability and may ___ the duration of the procedure.
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lengthen
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Not all patients are suitable for MIS. Some patients cannot tolerate the effects of ____
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insufflation (inflation of the abdominal cavity)
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All surgical risks depend on the condition of the ____ at the time of the surgery.
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patient
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Very sick patients are at greater risk of ____ problems, including those associated with positioning, abdominal insufflation, and the use of fluids to expand body cavities.
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physiological
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In laparoscopy the abdomen is filled with ____ ____
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carbon dioxide
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In arthroscopy (MIS of the joint spaces), the anatomical space is filled with ____ ____
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irrigation fluid
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Hollow organs, such as the bladder, are filled with ____ or other isotonic fluids during endoscopy.
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saline
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In some anatomical regions, such as the inguinal area, a ___ dissector is used to separate dense tissue planes without causing trauma.
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balloon
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In general, patient positioning for mIS is identical to that for ____
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open surgery
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For what kind of surgery is the patient tipped into reverse Trendelenburg position to displace abdominal viscera. (padded footboard, substantial padding is required to prevent nerve and vascular damage)
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Upper abdomen or lower esophagus
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During upper abdomen or lower esophagus MSI surgery the scrub must adjust the ___ or other overhead tables
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Mayo stand
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During upper abdomen or lower esophagus MIS surgery, if the table must be moved the circulator must ensure that the new position does not create ____ ____ between the patient and OR table.
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pressure points
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For ____ or lower abdominal procedures the patient is placed in the Trendelenburg position.
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Pelvic or lower abdominal procedures
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The Trendelenburg postion can compromise patient's lung capacity and cause hypotension from increased pressure on the ____ ____
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vena cava
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A gynecological patient is placed in the ____ position, which exposes the patient to risks associated with popliteal nerve and vessel injury.
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lithotomy
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Thoracoscopy or nephroscopy procedure of the lungs, bronchi, and upper urinary tract are performed with the patient in ____ position
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lateral
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Laryngoscopy, bronchoscopy, esophagoscopy, and mediastinoscopy procedures of the upper airway, upper gastrointestinal tract, and mediastinum are performed with the patient in ___ position
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supine
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A ____ patient undergoing bronchoscopy may be placed in the Fowler position.
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conscious
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To prep and drape the patient for an MIS is the same for an open procedure. This is particularly true for lap, retroperitonal, and thoracoscopic surgery bc they are more likely converted into other types of surgery
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NOTE ---->>>>
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If more light is required, the ____ is increased rather than light intensity.
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gain (the signal intensity)
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High-resolution video endoscopy requires very intense ___ light.
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white
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For the high-resolution video endoscopy ____ lamps are preferred
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Xenon
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The light emitted from the telescope is ___ as long as the light cable is attached to the telescope.
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cool
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Light rays emitted from the end of the cable when it is detached from the telescope are ____ hot.
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extremely
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The lightened end of the cable can ignite drapes, sponges, and other materials, especially in the presence of flammable or ignitable liquids such as ____.
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alcohol
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Always turn the light source to its ____ or standby mode before disconnecting it from the telescope or light cable
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lowest
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When storing or transporting a fiberoptic cable coil it ____.
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loosely
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Do not ___ a fiberoptic cable; instead store it in a flat position.
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hang
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Do not allow a fiber optic cable to strike a hard surface. This can cause the fiberoptic bundles to fracture. Internal fractures are not visible from the outside.
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NOTE ---->>>>
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Power ___ the light source before connecting or disconnecting a fiberoptic cable
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off
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Do not hande light source bulbs with bare hands. ___ ___ can reduce the life span of the bulb.
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skin oils
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Xenon light sources have bulbs that have a finite life, and ____ must be available during surgery.
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replacements
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All cameras must be ___-___ before each procedure.
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white-balanced
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White-balance is a procedure to adjust the ___ color to the other components in the system.
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light
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To white-balance the camera: connect it, turn it on high, and direct it to something white such as white paper and it will adjust automatically
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NOTE ---->>>>
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To white-balance the camera do not use porous or ___ material such as surgical sponge bc it can cause shadows on the image
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woven
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The optical angle are usually measured in degrees of 0, 30, and __.
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45
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The diameter of the telescope shaft is measured in ____
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millimeters (mm)
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The length of the telescope shaft, measured in ____.
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millimeters (mm)
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Power ___ the light source before connecting or disconnecting a fiberoptic cable
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off
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Do not hande light source bulbs with bare hands. ___ ___ can reduce the life span of the bulb.
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skin oils
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Xenon light sources have bulbs that have a finite life, and ____ must be available during surgery.
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replacements
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All cameras must be ___-___ before each procedure.
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white-balanced
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White-balance is a procedure to adjust the ___ color to the other components in the system.
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light
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To white-balance the camera: connect it, turn it on high, and direct it to something white such as white paper and it will adjust automatically
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NOTE ---->>>>
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To white-balance the camera do not use porous or ___ material such as surgical sponge bc it can cause shadows on the image
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woven
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The optical angle are usually measured in degrees of 0, 30, and __.
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45
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The diameter of the telescope shaft is measured in ____
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millimeters (mm)
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The length of the telescope shaft, measured in ____.
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millimeters (mm)
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Power ___ the light source before connecting or disconnecting a fiberoptic cable
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off
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Do not hande light source bulbs with bare hands. ___ ___ can reduce the life span of the bulb.
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skin oils
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Xenon light sources have bulbs that have a finite life, and ____ must be available during surgery.
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replacements
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All cameras must be ___-___ before each procedure.
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white-balanced
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White-balance is a procedure to adjust the ___ color to the other components in the system.
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light
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To white-balance the camera: connect it, turn it on high, and direct it to something white such as white paper and it will adjust automatically
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NOTE ---->>>>
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To white-balance the camera do not use porous or ___ material such as surgical sponge bc it can cause shadows on the image
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woven
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The optical angle are usually measured in degrees of 0, 30, and __.
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45
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The diameter of the telescope shaft is measured in ____
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millimeters (mm)
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The length of the telescope shaft, measured in ____.
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millimeters (mm)
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Telescopes are delicate and expensive the ST is responsible for ___ and maintaining the telescope in a manner that prevents errors.
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handling
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The circuit used in video endoscopy is called a ___-coupled device. (CCD)
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charge-coupled device
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The HD is __ times greater than the SD.
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7 times
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The endocoupler connects the ____ and telescope and is specific to the type of camera and scope in use.
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camera
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When transporting a camera hold it ____.
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firmly
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When connecting and disconnecting the camera head, make sure the lock ring is ____. Also make sure the camera is attached to the lock ring after engaging.
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disengaged
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After connecting the camera head to the telescope and camera is control unit, make sure the light is clearly emitted and is not ____.
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flickering
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The CCU should be able to convert SD to ___ signals or vice versa so that images from one format can be viewed by another.
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HD
CCU= Camera Control Unit |
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A resectoscope is a ridged telescope contained within a cutting and ____ instrument; it is used in the sectional removal of tissue.
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coagulating
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The ____ commonly is used in GI and gynecological surgery to remove tumors of the bladder and uterus and to resect the prostate.
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resectoscope
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The resectoscope is fitted with a ____ tip that uses laser or electrosurgical energy to remove tissue
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cutting
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Common specialty rigid telescopes: Laparoscope: ___ and pelvic surgery
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abdominal
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Common specialty rigid telescopes: ____ : joint surgery
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Arthroscope
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Common specialty rigid telescopes: Hysteroscope: Surgery of the ____
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uterus
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Common specialty rigid telescopes: ____: thoracic surgery
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Thoracoscope
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Common specialty rigid telescopes: ____: kidney surgery
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Nephroscope
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Common specialty rigid telescopes:Cystourethroscope: surgery of the ____ and associated structures
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Bladder
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Endoscopic instruments are designed to perform a precise surgical task in a ___ space.
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confined
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A rotational design, such as that used in ___ surgery, allows the tip of the instrument to swivel in a n arc, increasing maneuverability of the instruments.
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robotic
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The most common handle design is a transaxial type, which has two finger rings at a ___-degree angle to the long axis of the instrument.
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90-degree
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Endoscopic scissors are available in straight, ____, and hooked configurations.
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curved
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The trocar and cannula are assembled by the ST before ____
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insertion into the patient
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Cannulas are available in the following ranges:
Pediatric: __-__ mm Adult 5-10 mm Large and special purpose (specimen retrieval) 10-15 mm |
5-8 mm
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Abdominal surgery usually requires at least ____ trocars.
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three
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During abdominal surgery the video telescope usually is placed near the ____, approx 10 in (25 cm) above the pubic symphysis. Others are placed right or left of the midline.
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midline
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When CO2 is used during insufflation is ___ before it is used.
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warmed
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The insufflation unit is the ____ console for delivering the correct amount, temp, and pressure of CO2.
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control
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To create a pneumoperitoneum, the surgeon inflates the abdoment with CO2 through a large-bore needle called a ____ needle.
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Veress
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When a body cavity or organ is filled with ____ during surgery, the risk exists that it will be absorbed into the vascular system; this is called intravasation.
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fluid
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A ___ test is often done to verify the position of the Veress needle in the abdominal cavity.
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saline
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The pressure of the saline is usually maintained at __ to __ mm Hg.
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12-18 mm Hg
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(In the process of insufflation)
Before it is attached, the tubing is flushed with ____ to purge any air from the tube and prevent air embolism |
CO2 gas
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When the pressure of the irrigation exceeds a safe level, causing fluid to enter the vascular system and thereby increasing ____ ____.
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blood pressure
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The circulating nurse and the ___ monitor fluid pressure during fluid distention procedures.
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surgeon
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The circulating nurse and scrubbed surgical tech share responsibility for keeping track of the amount of ___ used and the amount of runoff during the procedure.
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fluid
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The balloon dissector is used in reconstructive plastic surgery and in ____ and abdominal wall procedures.
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vascular
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All MIS instruments are insulated with materials that do not ____ ___.
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conduct electricity
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A capacitor is a point in an electrical circuit where energy is built up or ____ between insulators.
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stored
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The most effective means of preventing burns is ____ ____ ____ (AEM), a system in which the instruments are self-monitoring during use.
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active electrode monitoring
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Ultrasonic technology is used during MIS for _____ and cutting.
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coagulation
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Ultrasonic energy coagulates tissue by creating a ___ coagulum at the cellular level.
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cool
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Ultrasonic energy uses no ___ energy and very little heat are involved.
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electrical
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Bipolar energy can be an effective method of hemostasis when the combination of low ___ and high ____ is used.
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low power and high frequency
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In the extracorporeal suture technique, the knot is tied ____ the the body cavity and then pushed into place with a knot pusher.
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outside
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In the intracorporeal technique, the suture is knotted and tightened ____ the body with two grasping instrument inserted into two separate cannula ports.
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inside
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Ligation loop is...
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a loop of suture contained in a carrier, similar to a snare is delivered through the laparoscopic and looped around the tissue, tightened, and ends are cut.
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Telescopes should be maintained on a ___ or other soft surface to prevent them from rolling off the table.
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towel
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____ clamps must be used to secure cords and tubing to drapes. (fiberoptic and camera cables)
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Nonpenetrating clamps
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Always allow sufficient ___ on cord attachments and be alert to changes in table position, which can cause cords to be dragged.
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slack
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Give some examples of some MIS procedures that could turn into an open case
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laparoscopy, pelvic, and thoracic surgery
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The flexible endoscope is most often used for examination, visual exploration, and ____.
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biopsy
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The flexible endoscope has two main sections, the head and the ____ tube.
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insertion
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The water channel on the endoscope is used to clear ____ and tissue debris from the lens.
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blood
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The ____ channel is used to manipulate instruments and remove tissue specimens.
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elevator channel
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Flexible endoscopy usually is performed in an ____ setting
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outpatient
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