What to expect:
1.Position of patient
2.Primary port closed entry
3.Secondary port entry
4.Primary port alternatives
5.Exit techniques
6.Reference to RCOG Green Top Guideline 49 - PREVENTING ENTRY-RELATED GYNAECOLOGICAL LAPAROSCOPIC INJURIES
1. Position
- Prone -Stirrups/Lloyd Davis -Non slip mattress -Trendelenberg after ports
- The operating table should be horizontal (not in the Trendelenberg tilt) at the start of the procedure
- The abdomen should be palpated to check for any masses before insertion of the Veress needle
-
Fixed peritoneum -Thin -Least vascular -Cosmetic
- The primary incision for laparoscopy should be vertical from the base of the umbilicus (not in the skin below the umbilicus)
- Care should be taken not to incise so deeply as to enter the peritoneal cavity.
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Insertion of Veress needle
Pencil grip
Vertical, then towards pelvis
Double “click”