Safety in Minimal Access Surgery: Evidence and Recommendations Om Tantia, Tamonas Chaudhuri
INDEX
Page numbers followed by b refer to box, f refer to figure, and t refer to table.
A
Abdomen 288
computed tomography scan of 288
exploration of 195
Abdominal access 225, 268
Abdominal cavity 58
access to 58b
Abdominal sac volume 237
Abdominal surgery
multiple 223
previous 160
Abdominal veress needle entry and port-placement 290
Abdominal wall hernia
classification of primary 221, 221t
treatment of 221
Abdominal wall reconstruction 235
Abscess 87f, 170
appendicular 173
intraabdominal 87
small 173
Achalasia 140, 141, 142f, 148, 149
cardia 140, 141f
Chicago classification of 143b
safety in surgery for 140
treatment for 150
clinical assessment 140
diagnosis of 141
investigations 141
subtypes of 143, 143f
treatment of 140, 148
Achilles's heel 244
Active cancer
diagnosis 277
treatment 277
Active electrode tip
small-surface 24
type of 23
Active enterocutaneous fistula 224
Acute cholecystitis 67, 73
Adenocarcinoma 90
Adhesiolysis 223, 226
Adhesion formation 160
Adnexal pathology 285
Adrenal anatomy 122f
Adrenal arteries 124
Adrenal cyst 121
Adrenal glands 122
Adrenal mass 119
Adrenal tumours 124
Adrenalectomy, bilateral 125
Adrenocortical carcinoma 119
Adrenocorticotropic hormone 119
Advanced laparoscopic procedures 38
Advantages over open hernia repair 203
Aerobic organisms 169
Airborne infection isolation requirements 53
Air-conditioning system, non-circulating 1
Albendazole 100
Alexander technique 42
Alkaline solution 15
Allergic reaction 103
Altemeier procedure 178, 183, 184f
Alternative veress needle insertion sites 60
Alvarado score 169
Amalgamated retrorectus spaces 240f
American Association of Gynaecological Laparoscopy 294
Americas Hernia Society Quality Collaborative 236
Amoxicillin 111
Anadvertent cystostomy, bladder repair for 295
Anadvertent injury, identification of 63
Anaemia 128, 279
Anaerobic organisms 169
Anaesthesia 5, 6, 15, 47, 68, 144
considerations 53
induction of 6, 140
local 49
machine 46
method 83, 289
patient-controlled 48
station 47
technique 48t
Anaesthetic management 45
Analgesia, post-operative 175
Anastomosis 279
Anastomotic leak
operative factors for 161
patient-related factors for 160
Anorectal junction, descent of 179f
Anorectal manometry 180, 181f
Anterior abdominal wall 228
Anterior colpotomy over colpotomiser 293f
Anterior component separation 241, 244, 244f
Anterior gastrotomy 92, 92f
closure of 93f
Anterior rectus sheath 206f
incision 206f
Anterior superior iliac spine 210, 212, 291
Anterior wall vascularity 287f
Anterolateral muscles, lateral traction of 237f
Antibiotics 218
pre-operative 83, 194
prophylaxis 111, 204
Anticoagulant 204, 216
Antireflux surgery 135
Antisepsis 11
Anti-slip mattresses 45
Appendicitis 169, 170b, 174
diagnosis of 169
perforated acute 174
recurrent acute 174
Appendicolith, absence of 170
Appendix 172
abnormal 175
abscess 173
peration for 173
division of 172f
ligation of 172f
normal 175
Artificial implantable cardioverter defibrillators 3
Aspiration 99, 141, 218
prevention of 144
test 60
Asymptomatic cystic lesion cysts 100
Atypical mycobacteria, suspensions of 15
Autoimmune
haemolytic anaemia 111
lymphoproliferative syndrome 110
Azimuth angle 37
B
B cells, production of mature 117
Bactericide 11
Bailout procedures 74, 75f
Balloon dissection 208
Banded gastric
bypass 275
pouch 274
Banded sleeve gastrectomy 276
Bare posterior rectus sheath 208f
Bariatric metabolic surgery 267, 277
Standardization World Consensus Meeting 268
Barium oesophagogram 141, 141f, 142f
Barrett's oesophagus 135
Bellhouse-Doré score 6
Bilaminar meshes 241f
Bilateral transversus abdominis release incisions 243f
Bile leak 76, 87
Biliary communication 101
Biliary cystadenoma 98
Biliary tree, inadequate clearance of 86
Bipolar current flow 23f
Bipolar electrosurgery mode 23
Bipolar energy 171
Bipolar mode 3
Bird-beak’ appearance 141
Bladder 287f
emptying, preoperative 204
flap, dissection of 292, 292f
injury 295
ligament
anterior 287f
posterior 287f
Blade motion couples with tissue protein 31
Bleeding 128, 198, 231
complications, post-operative 198
gastric varices 109
intra-operative 299
Blood
borne viruses, generate aerosolisation of 52
group 251
pressure, non-invasive 46
Blunt dissection 70
Blunt-tipped
scissors 72
trocars 201
Body mass index 59, 200, 235, 279
Bogros’ space 196
Bone marrow depression 100
Bony prominences 159
Borchardt's triad 128
Botulinum toxin 140, 238, 238f
Bowel
adhesions 226
injuries 57, 77, 230, 295
obstruction 158
preoperative preparation of 288
preparation 155
advantages of 224
preoperative 224
Bravo capsule PH system 129
Breathing system 5
Bulging mucosa 145f
C
Caecostomy 173
Calcified splenic artery 110
Calcium 284
Calot's triangle 73, 77
dissection of 70, 84
Camera system 205
Cameroon's ulcers 128
Cancer surgery 109
Cannula system 102f
Carbohydrate antigen 90
Carbon dioxide 206, 207
insufflators 205
Carboxymethyl-cellulose 228
Carcinoembryonic antigen 90
Cardiac shunts, right-to-left 45
Cardiopulmonary disorders 155
Cardiovascular disease 279
Cave of Retzius 243
Cellulitis 232
Central venous pressure 46
Cephalo-caudal length 116
Cervical intraepithelial neoplasia 285
Chemical
disinfection 14
sterilisation 2
Chest pain 141
Chicken wing scapula 41
Child-Pugh C cirrhosis 67
Cholangiogram, intraoperative 77
Cholangiography, pre-operative 86
Cholangitis 80
Cholecystectomy 66, 82
subtotal 74
Cholecystitis
acute
acalculous 66
calculus 66
Choledochoduodenostomy 86, 86f
Choledochoenterostomy 82
Choledocholithiasis, concomitant 66
Choledochoscopy 76f, 84
Choledochotomy 84f
Chromosomal aberrations, high number of 17
Chronic obstructive pulmonary disease 236
Cirrhosis 73, 74f, 277
Clipping cystic artery 69
Closed jejuno-jejunal anastomosis 271f
Closing hernia defect 227, 227f
Clostridium 15
difficile 130, 194
CMR versius robot 303f
Coagulate tissue bundle 30
Coagulation 24
Cobweb 208f
Cold agglutinin disease 110
Collar technique 260
Colon ischaemia, proximal 163
Colonic resection, right-sided 156
Colonoscopy 178
Colony forming units 10
Colorectal cancer 153
Colorectal surgeons, adequate structured training of 157
Colorectal surgery
after 163
complications 158
management 158
post-operative care 163
safety in 152
Colpotomy 293
Common bile duct 30, 80, 85f, 103
choledochoscopic view of 76f
closure 86f
exploration 76f
injury 70, 86
junction 87
stone 81f
concomitant 75
intraoperative cholangiography of 81f
stricture 87
subsequent 77
Common hepatic duct 68
Complete blood count 188, 251
Complex midline incisional hernia 237f
Composite mesh 217, 228
Computed tomography 90, 110, 239
scan 120f, 283, 288
use of 239
Computerised tomography 99
scan 268
Concomitant laparoscopic procedures 82, 219
Concomitant surgery 285
Conductive metal cannula 25, 29
Connects inferior epigastric artery 193f
Contrast enhanced computed tomography, pre-operative 110
Cooper's ligament 193, 193f, 210, 211f, 216, 242
Cord
parietalisation of 196, 197f, 213f
structure
injury to 200
parietalisation of 212
Cornual pedicles 292
Corona mortis 193, 193f, 210
Coronary artery disease, unstable 277
Corticosteroids 204
Cosmesis 174
COVID-19 49, 51, 54
despite, risk of contracting 53
infection, risk of 55
presentations of 54
test 51
warriors 55
Cranial displacement 205
Crohn's disease 174, 277
Crotch staples, removal of 258f
Crural repair 132
calibration of 132
reinforcement of 133
Cruroplasty 133f
Cushing's syndrome 119
Cyst 101, 104
enterogenous 90
Cystadenocarcinoma 90
Cystectomy, partial 98
Cystic artery 69, 71
Cystic duct 68, 87
clipping 71
orifice 87
Cystic echinococcosis 98101
complications of 98, 103
locations of 99
management of 98
surgical management of 101
treatment of 99
ultrasonographic classification for 99t
Cystic lesion 99
Cystitis 200
Cystobiliary communication 101
Cystogastrotomy stoma 92f
Cystojejunostomy, side-to-side 94
Cystoscopes 11
Cystoscopy, post-operative 294
D
Debridement 92, 93
Decompression 93
Deep vein thrombosis 111, 251, 283
prophylaxis 251
Delayed bowel complication 296
Delorme's procedure 183, 184f, 185
Denonvilliers’ fascia 186
Dermoid cyst 90
Desiccation and securing uterine vessels 293f
Dexmedetomidine 48
alpha 2 agonist 49
Diabetes mellitus 66, 80, 121, 204, 267, 279
Diagnostic laparoscopy 171
Dialysate delivery systems 15
Diaphragmatic hiatus 127
Diarrhoea 130
Diathermy, safety during use of 3
Difficult laparoscopic cholecystectomy 67
pre-operative identification of 66
Digital rectal examination 178
Dilated common bile duct 67
Diluted glutaraldehyde 10
Direct current voltage 21f
Direct hernia 193, 193f, 197
Direct trocar 62, 64
Disability adjusted life years 1
Discomfort free laparoscopic surgery 42
Disposable hand instruments 205
Disposable trocars 64
reuse of 64
Disposable Veress needle 58f
Dissection
distal extent of 255f
posterior 69, 70
Distal oesophagus 141
Diverticulitis 160
Docked surgical robot 298f
Dorsal decubitus 59
Double click sound test 59
Double-glove technique and face shield 50
Drains 274
Duodeno-jejunal flexure 282f
Dynamic MRI pelvis 179f
Dysphagia 128, 136, 141
E
Echocardiography 251
Eckardt score 141t
Ejaculation, absence of 160
Elastin fibres, depletion of 128
Electrocardiography 27
Electrogoniometers 33
Electromyography 33
Electrosurgery 3, 21, 22, 31t, 172
basics of 21
despite delivering voltage 22
modes in 22
Electrosurgical injuries 25
Electrosurgical unit 22, 28f, 29
Elevated lymphocytes 17
Empyema 73
Endobag, use of 72f
Endocrine tumour 90
Endolinear cutter 92
Endo-luminal procedures 55
Endometrial hyperplasia 285
Endometriosis 285, 288
Endoscope 11, 15, 36
Endoscopic
decompression, procedure for 91
hernia repair 204
mucosal resection 55
onlay approach 246, 247f
preaponeurotic repair 246
procedures 54
retrograde cholangiopancreatography 80, 82f, 90, 95
therapy 135
ultrasound 80, 90
Endoscopy 54
role of preoperative 268
Endotracheal tube 46
End-stage lung disease 277
End-tidal carbon dioxide continuously 46
Energy
concentration of 28
device recommendations 54
Enhanced recovery after surgery 157
protocols 261
Entero-enteric anastomotic site 272f
Entero-enterotomy 271f
Enterotomy 282f, 283
closing of 231f
Enzyme-linked immunosorbent assay 99
Epidemiologic studies 12
Epigastric
abdominal wall hernias 224
vessels 211
Epigastrium 243f
Epiphrenic diverticula 149
Equipment inside operation theatre 1
Ergonomics 32, 68
safety tips in 39
Erythromycin 111
Ethylene oxide 11, 14
chamber 2
sterilisation 16
European Hernia Society 221
Extensive adhesiolysis 231
External oblique aponeurosis 244f
Extra pancreatic cyst 90
Extra-peritoneal
access 206
fascia 211
space 207, 209
F
Face surgery 4
Faecal fistula 173
Faecal incontinence 178
Falciform ligament hitch 260
Fallopian tube 287f
Fascia 178
transversalis 210
Fascial defect 240
Fasting and post-prandial
blood sugar 251
C-peptide levels 251
insulin levels 251
Feasible technique 117
Fecal incontinence 181f
Felty syndrome 109
Femoral defects 219
Femoral hernia recurrence 219
Finish National Insurance Association 57
First laparoscopic appendectomy 169
Fistula, enterocutaneous 174
Flank hernias 225
Flexible choledochoscope 85f
Flexible endoscope 146f
Fogarty balloon catheter 85
Folate 284
Foley's catheter 295
Food and Drug Administration 11
Foot pedals 34, 35
Force platforms 33
Formaldehyde fumigation 2
French position 251
Frequent multiple training methods 8
Frozen Calot's triangle 74
Frykman-Goldberg procedure 183
Fulguration 24
Fundal
mobilisation 133
sutures 134f
traction 69, 70f
wrap 134f
Fundoplication 146, 147
addition of 147
partial 135
Fundus first cholecystectomy 74
Fungicide 11
G
Gall bladder 72, 74, 74f, 80
fossa 72
laparoscopic view of 66
Gallstones, asymptomatic 66
Gamma-aminobutyric acid 199
Ganglioneuromas 119
Gangrenous bowel 223f
Gangrenous gall bladder 73
Gas
concentration 16
evacuation 55
plasma sterilisation 14
Gastric
bypass 275, 275f, 279
emptying scintigraphy 129
myotomy 145, 145f
outlet obstruction 94
pouch 280
veins 117f
Gastro-colic ligament 112
Gastroenterostomy anastomosis 273f
pouch for 273f
Gastrointestinal injuries, incidence of 57
Gastrointestinal procedure 152
Gastro-jejunal anastomosis 281
Gastro-jejunostomy 271
anastomosis, formation of 273f
formation of 270, 274
linear stapled posterior wall 273f
Gastro-oesophageal
disease 136f
junction 127, 253, 275f
reflux
abnormal 129
disease 141, 251, 275, 279
Gastrosplenic ligaments 108
Gastrostomy, closure of 93
Gaucher disease 110
Gelport laparoscopic systems 40
General anaesthesia 48, 67, 170, 194, 289
risk for 185
Geobacillus stearothermophilus 13
Germicide 11
Glove barrier failure 3
Glutaraldehyde 11, 14, 15
formulations of 15
Glycaemic control 236
Glycosylated haemoglobin 251
Gonadotropin-releasing hormone 288
agonist 288
Grading System of Infectious Diseases Society of America 98t
Greater omentum, division of 253
Griffen modified Roux-en-Y gastric bypass 268f
Groin hernia, repair of 192, 203
Ground fault circuit interrupter 3
Grounded power system 3
Gut microbiota 161
H
H2O2 gas sterilisation 16
Haematological disorders 110
Haematomas 198
Haematuria 200
Haemogram 67
Haemolytic anaemia, congenital 66
Haemophilus influenza type B vaccine 110
Haemorrhage 95, 117, 159
Haemostatic laparoscopic devices 254
Hairy cell leukaemia 109
Hand
hygiene 52
instruments 205
sewn gastro-enterostomy 273f, 275f
Hand-assisted laparoscopic
splenectomy 107
surgery, concept of 40
Hand-assisted surgery 54
Handle-shaft angle 38, 38f
Hanging drop test 60
Harmonic scalpel 92
Hartman's pouch 67
Hartmann's takedown 153
Hassan's cannula 62f
Hassan's technique 61
Hawthorne effect 33
Head surgery 4
Heart failure, severe 277
Heartburn 128, 141
Helicobacter pylori 279
testing 251
Heller myotomy, technique of laparoscopic 144
Hematoma 217, 218
Hemicolectomy, partial right 173
Hepatic cirrhosis 110
Hepatic diseases 3
Hepatic duct stones 86
Hepatic echinococcosis 98
Hepatic venous pressure gradient 259
Hepatotoxicity 100
Hernia 204, 224
bilateral 206, 215
central 225, 225f
complicated 218
contents of 221
defect 225f, 227, 227f, 228, 228f
multiple 222, 222f
single 222f
hiatus 127, 128, 128f, 251
irreducible 223f
laparoscopic repair of 233
large complete 204
lateral 221, 222, 247
location of 221
medial 221
operations 200
orifice 197
port-site 205
recurrent 219
reduction of 206
repair 235, 239
previous 222
sac 197, 200
large 224
reduction of 196, 197f
volume 237
size of 221, 222
subxiphoidal 230
type of 197
unilateral 206
Hernial defect, suturing of 300f
Hesselbach's triangle 210, 216
Hiatal dissection 131
Hiatal reinforcement techniques 133
Hiatus hernia 127, 128, 128f, 251
aetiopathology 128
classification of 127
clinical symptoms 128
diagnosis 128
endoscopy 129
medical treatment 130
operative technique 131
safety in surgery for 127
surgery 130
surgical treatment 130
symptoms of 129
type of 129
High blood pressure 121
High-definition camera system 205
High-resolution manometry 129, 142, 143f
Hilar mobilisation 114
Hissing sound test 60
Holmium laser 84
Hook electrode 92
Huge dilated splenic veins 117
Human leucocyte antigen 109
Hydatid
disease, incidence of 105
membranes, presence of 104
system, correct use of 102f
Hydrogen peroxide 15
plasma sterilisation 17
Hyperaldosteronism 119
Hypertension 216, 279
Hypochlorite 11
Hypochlorous acid 11
Hypokalaemia 121
Hysterectomy 285
indications for 285t
types of 286
I
Iatrogenic ureteric injury 159
Iliohypogastric nerves 212
Ilioinguinal nerves 212
Iliopubic tract 193f, 210
Immune thrombocytopenia 109, 110
Immunoelectrophoresis 99
Imperial College Surgical Assessment Device 33
Inadvertent cystotomy 295
Incarcerated hernia 223
Incision
laparoscopy 40
surgery, single 40
types of 196f
Incisional abdominal wall hernia, classification of 221
Incisional hernia 175, 222, 224, 229
width and length of 222f
Indian Society of Anaesthesiologists 53
Indian Yoga System 42
Indocyanine green 86
fluorescence angiography 162
Indwelling catheter 159
Infectious diseases 49
Inferior epigastric
artery 198
vessels 193f, 208, 211, 211f, 212f
Inferior mesenteric artery 186
high ligation of 157f
Inferior vena cava 122f, 123, 288
Infertility 218
Inflammatory process, post-operative 217
Infracolic Roux-en-Y cystojejunostomy 94f
Infraumbilical incision 59
Infundibulopelvic ligament
desiccation of 292f
transection of 292f
Inguinal hernia 192, 193, 204, 219, 239
complicated 218
repair 192, 198, 199, 219
Inguinal herniorrhaphy 219
Inguinal ligament 193, 210
Inguinal pain, post-operative 199
Inguinal paraesthesia 217
Inguinal region, laparoscopic view of 192f
Inguinodynia, chronic 217
Initial retrocolic endoscopic tunnel approach 157f
Injuries near surgery site 26, 27
Insufflation test 60
Intact large right adrenal specimen 124f
Intact left adrenal specimen 124f
Interleukin, high levels of 104
Intermittent pneumatic compression devices 283
International Federation of Obesity and Metabolic Surgery Registry 279
International normalised ratio 116
International Organization of Standardization 10
International Sleeve Gastrectomy Expert Panel Consensus Statement 259
Intra-abdominal adhesions 195
Intra-abdominal pressure 60, 155
reduction of 227
Intra-abdominal veins, compression of 69
Intra-biliary rupture 103
Intra-corporeal suturing 92
Intra-luminal stapled laparoscopic cystogastrostomy 95
Intraoperative endoscopy 145, 146f
role of 268
Intraoperative enterotomy, management of 230
Intraoperative leak test 259
Intra-operative ultrasonography and Doppler study 92
Intraperitoneal mesh placement 240
Intraperitoneal onlay mesh repair 219, 221
Intraperitoneal rupture 101, 104
Ipsilateral rectus 207
Iron 284
Ischaemia 128
Ischaemic orchitis 200
Ispaghula 182
J
Jain point 60
Jejunojejunostomy 271f
Jejunostomy 86
Jejunum, Roux-en-Y loop of 91
Jorge-Wexner score 178, 178t
K
Kidney function tests 251
Koh RUMI manipulator 290f
insertion of 289f
Kustner's window 131f
L
Lactulose 182
Laparoscopic adrenalectomy 120, 121
Laparoscopic anti-reflux surgery 131, 136
Laparoscopic appendectomy 170
Laparoscopic cholecystectomy 34, 66, 69f, 75, 81
safe completion of 68
Laparoscopic choledochotomy 81
Laparoscopic colectomy 155
step of 156
Laparoscopic colorectal procedure
perform 153
spectrum of 153
Laparoscopic colorectal
resection, safety of 155
surgery 157, 158, 164
Laparoscopic common bile duct exploration 84t
Laparoscopic cystoduodenostomy 93
Laparoscopic cystogastrostomy 91, 96
Laparoscopic cystojejunostomy 93
Laparoscopic devices, sterilisation of 14
Laparoscopic entry technique 63
Laparoscopic heller myotomy 140
Laparoscopic hernia 198
group 201
operation 201
Laparoscopic hernioplasty 193
Laparoscopic hysterectomy 285, 286f, 294, 296
classification system of 285, 286t
indications of 285
types of 286f
Laparoscopic inguinal hernia 198
repair 198, 203
Laparoscopic instrument 16, 35
biomechanical demands of 35
design 34
safe use of 17
sterilisation of 14
zones in 28f
Laparoscopic left inguinal hernia repair 193f
Laparoscopic modified left paracolic approach 93
Laparoscopic oesophagogastroplasty 149
Laparoscopic procedures 186
Laparoscopic repair 219, 223
advantages of 192
contraindications for 223
Laparoscopic sigmoid resection 186
Laparoscopic sleeve gastrectomy 250, 260
Laparoscopic splenectomy 118
Laparoscopic subtotal hysterectomy 286
Laparoscopic surgery 32, 42, 57, 101, 154, 164, 223
energy sources in 21
haptics in 40
Laparoscopic technique 40
Laparoscopic trans-abdominal
approach 121
position 123f
Laparoscopic transcystic technique 81
Laparoscopic vision 132
Laparoscopy 21, 153
basic principles of 36
Laparotomy 285
multiple previous 67
regarding conversion to 174
Large prosthetic mesh, removal of 224
Large uterus, power morcellation for 293
Larger well-defined abscess 173
Laryngeal masks 206
Lateral incisional hernias, classification of 222f
Laxative therapy 182
Leak test 282
Lee Huang point 60
Left adrenal ports 124f
Left adrenal vein 124f
Left adrenalectomy 124
Left colic artery ligation 162
Left gastro-omental vessels 108
Left hepatic artery 131
Left spleno-pancreatic space 122f
Leiomyomata 285
Leiomyosarcoma 90
Lesser curve, horizontal aspect of 281f
Leukaemia, chronic lymphocytic 109
Liga clips, normal 123
Ligament of Treitz 270f
Ligamentum teres 133
Light-emitting diodes 299
Lightweight meshes 217
Limb length 274, 280
Line isolation
monitor alarm 3
transformer 3
Linea semilunaris 211, 240f, 242f
Liver
aminotransferases 100
cirrhosis 66, 67, 259
function test 80, 251
hydatid disease 98
management of 98
retraction 253
suspension tube technique 253
synthetic function 259
Living tissue, effect of temperature on 22t
Lord Ganesha's sign 71, 71f
Low colorectal anastomosis 162
Low frequency currents 26, 29
Low molecular weight heparin 186, 251, 283
Lower abdominal wall hernias 225, 226f
Lower biliary leakage 101
Lower limbs, bilateral venous colour Doppler of 251
Lower oesophageal sphincter 140, 143, 260
Lung cysts 100
Lymphocyte 51
Lymphoma 90
M
Machine
leak check 47
safety of 298, 301
Magnetic resonance
cholangiopancreatography 76, 80, 81f, 90, 95
defecography 180
imaging 90, 99
Malignancy, suspicion of 89
Mangeshikar uterine manipulator 290f
Manipulation angle 37, 39, 40f
Manometer test 59
Manometry
findings, treatment on 143
high-resolution 142
Manufacturer's guidance 13
Maryland dissector 70
Mason-Ito loop gastric bypass 267f
Mass, appendicular 173
Meckel's diverticulitis 175
Medial dissection 211
Mediastinal oesophagus 132
Medical compressed air 2
Medical devices 12
Medical vacuum 2
Medtronic robot 303f
Megaoesophagus 149
Meningococcal vaccine 110
Mesenteric defect, closure of 272f
Mesenteric vein, superior 107
Mesh
caudal end of 214
cruroplasty 133
deployment 229f, 241
planes for 240
fixation of 188f, 197, 197f, 215
infection 217, 232
prevention of 233
placement of 187f, 197, 213
rectopexy 186, 187
posterior 183
related complications 200
safe deployment of 229
Mesoappendix 172
division of 172f
Mesocolic excision 156
Metabolic derangements 121
Methylene blue dye 159
Metronidazole oral antibiotic 185
Microalbuminuria 251
Micronutrient 262
supplementations, post-operative 284
Microorganism 11
type of 11
Micro-porous 217
Midline hernias 221
Midline incisional hernias, classification of 222f
Midline port 208, 209f
Mini-gastric bypass 80
Mini-laparotomy 61
Minimally access surgery 34, 45, 51, 57, 152
related surgeon morbidity syndromes 32
safety in anaesthesia for 45
Minimally invasive
approach 185, 186
procedures 185
surgery 47, 48t
limitations of 32
pain management in 49t
Minimises blood loss 21
Mirizzi's syndrome 66, 67, 74, 75
Mixed hiatus hernia 127f
Mobilise bladder 292
Modern anaesthesia workstation 46
Modern low flow delivery systems 47
Modern neurosurgery, father of 22
Moisture exchange filter 46
Monarch Robotic platform 303f
Monitors positioning 206
Monopolar current flow 23f
Monopolar electro surgery 23, 54
Monopolar instrument
cable 22
injuries along axis of 26, 28
Monopolar mode 3, 22
Morbid obesity 136, 148, 235
Movement, choreography of 38
Mucocele 73
Mucosal breach 145
Multi-compartmental abscess 173
Multidisciplinary sharps
injury prevention plan 8
safety committee 8
Multiple vascular control 152
Muscle 178
stimulation 26, 29
Muscularis propria 184f
Musculoskeletal disorders, appearing of 42
Mycobacterial infection 217
Mycobacterium
chelonae 217
tuberculosis 15
Myelofibrosis 111
primary 109
Myelolipoma 119
Myeloproliferative disorders 107
Myopectineal orifice 196, 196f
Myotomy 146f
completeness of 146f
extent of 146
intraoperative confirmation of completeness of 147
N
Narrow pubic arch 285
Nasogastric tube 148
placement 135, 204
Nathanson's retractor 131
Natural orifice transluminal endoscopic surgery 152, 164
Nausea
and vomiting, history of post-operative 49
post-operative 48, 49, 259
Neck surgery 4
Necrotic appendix 173
Negative intra-abdominal pressure 59
Neoadjuvant therapy 53, 160
Neural diseases 3
Neuromuscular evaluation 181
Neuromuscular stimulation 22
Neuropathies, post-operative 45
Neuro-physiological testing 181
Neurovascular bundles, appearance of 242f
Neurovascular complications 158
Neutrophil 51
Nissen's 360° wrap 134
Nissen's wrap 135
Nitrous oxide 2
Non-alcoholic steatohepatitis 259
Non-conductive trocar 29f
Non-critical items 10, 11
Non-operative treatment 170
Non-steroidal anti-inflammatory drugs 49, 199
Non-surgical interventions 53
Normal power setting 30
Nulliparous pelvis 285
Nutritional deficiencies symptoms 284
Nutritional status 160
O
Obstruction 128
Obstructive sleep apnoea 279
Obturator artery 193f
aberrant branch of 193f
Obturator sign 169
Oedema 67
Oesophageal acid 128
Oesophageal circumference 145
Oesophageal emptying, preoperative 144
Oesophageal hiatus, calibration of 133f
Oesophageal lumen 144
Oesophageal manometry 129, 141, 142
Oesophageal mobilisation 131
Oesophageal muscle fibres 145f
Oesophageal myotomy 144, 145f
Oesophageal peristalsis, absence of 140
Oesophageal peristaltic waves 142
Oesophageal pressurisation 142
Oesophagectomy 149
Oesophagogastric junction 148f
Oesophago-gastro-duodenoscopy, preoperative 279
Oesophagus 132
following dissection, intra-abdominal length of 132f
length of 132
segmented 141
sigmoid-shaped 141f
Ohm's law states 21
Omental adhesions 226
Omentopexy 258f
Open Hasson's technique 252
Open periumbilical perforator sparing technique 244
Operating room 51
Operating surgeon's eyes 36
Operating table 205
height 34
Operation theatre 1
fire safety in 3, 4
layout 83, 83f
measures in 2
patient position 34
safety in 1
set-up 158
table height, role of 34
Operative technique 206
Opioids 199
Optical access trocars 201
Optical trocars 62, 63f, 64f, 252
entry 64
specialised 58
Oral contraceptive 111
Orchialgia 200
Orchitis 218
Organs, abdominal 175
Ortho-phthalaldehyde 11
Ovarian preservation 292f
Overshoot injury 58
Overwhelming post-splenectomy infections 110
P
Pain 199, 231
management
multimodality 48
post-operative 48
post-operative 49
triangle of 193
Palanivelu hydatid
system, use of 102
trocar 102f
Palmer's point 69, 291
Pampiniform 213f
plexus 212
Pancreas, cystic neoplasms of 90
Pancreatic duct 89
Pancreatic fistula 95
Pancreatic pseudocyst 89
Pancreatico-splenic ligaments 109
Pancreatitis 75, 80
acute 80
Paracetamol 49
Paraganglioma 119
Parallel port technique 252
Parasitic cyst 90
Paroxysmal cold haemoglobinuria 110
Pathogenic microorganisms 15
Pathogenic microorganisms, removal of 10
Patient plate injuries 26
Pectineal ligament 197
Pelvic abscess 173
Pelvic drainage 163
Pelvic pain, chronic 285
Pelvic region, laparoscopic anatomy of 287
Pelvis 175, 178
anatomical view of 287f
Pendant services 2
Penetrating fixation techniques 198
Per-acetic acid 11, 14, 16
Percutaneous antibiotic irrigation 218
Percutaneous cholecystostomy 73
Percutaneous drainage 53
Percutaneous transgastric drainage 94
Percutaneous transhepatic biliary drainage 53
Pericholecystic fluid 67
Pericystectomy, partial 101
Peri-gastric window, creation of 269f
Perineal approach 183
Perineal recto-sigmoidectomy 184f
Peritoneal flap, creation of 195f
Peritoneal incision
posterior 70f
right crus 132f
Peritoneal lavage 174
Peritoneal metastasis 156f
Peritoneal sac 196
Peritoneal tears 200
Peritoneum
closure of 188
re-approximation of 198, 198f
violation of 216
Peritonitis 80
Perityphlitis 169
Permanent pacemaker, issue of 3
Per-oral endoscopic myotomy 140
Personal protective equipment 51
strict use of 55
Petersen's defect 283
closure of 272, 274f
Pfannenstiel incision 116
pH monitoring 129
Pharmaceutical management 99, 100
Phenolics 10
Pheochromocytoma 119
Phlegmon 173
Phreno-oesophageal membrane 132
Phrenosplenic ligament 109, 116f, 117
lateral part of 115
Physical ergonomics 41
Physical resources domain 51
Pigmented nodular adrenocortical disease, primary 119
Planning operation theatre 1
Plasma steriliser 2
Pneumatic lithotripter 84
Pneumobilia 67
Pneumococcal conjugate 13-valent vaccine 110
Pneumococcal polysaccharide 111
Pneumonia 206
Pneumoperitoneum 58, 69, 155, 170, 216
adequate 60
creation of 251
progressive preoperative 237
risks of 45
Polar artery, superior 114f
Polydioxanone 215
Polyethylene glycol 228
Polyp, rapidly increasing size of 66
Polypropylene 227
mesh 215
Polytetrafluoroethylene 228
Port closure 73
Port insertion 268
horizontal 207f
Port placement 195, 208, 252, 268
basic principles for 38
principles of 38
specialised trocars for primary 62
Port position 91f, 113f, 253f, 291f
Portal hypertension 67, 259, 277
Positive end-expiratory pressure 47
Post-cholecystectomy 81
Post-endoscopic retrograde cholangiopancreatography status 67
Posterior adhesions, dissection of 254
Post-laparoscopic cholecystectomy 76
Post-operative complications 231
Post-vagus 132f
Powered air purifying respirators 55
Pre-emptive
analgesia 49
drugs 49
Preparing mesh 228
Preperitoneal mesh placement 240
Preperitoneal plane 203
Preperitoneal space, creation of 195
Pressure controlled ventilation 47
Preventing infection, measures of 1
Previously operated contralateral hernia 219
Prolapse, appearance of 177
Prolonged ileus 231
Prolonged laparoscopy 36
Proper enterotomy closure 282f
Prophylactic antibiotics 225
Prophylactic appendectomy 175
Prostatic symptoms, preoperative 200
Prosthesis 226, 228
Prosthetic material for hernia repair 192
Protective clothing 3
Protective drapes 3
Protein
calorie malnutrition, severe 280
denaturation of 24
disorganises 31
hydrogen bonds 31
Proton pump inhibitor 283
Proximal biliary tree, clearance of 85
Proximal sac 213
Pseudoaneurysm 95
Pseudocyst 95f
complicated 94
endoscopic drainage of 90
surgical drainage of 91
Pseudopancreas cyst, safe surgery for 89
Psoas sign 169
Psychosocial organisational factors 8
Pubalgia 200
Pubic symphysis 197
Pubococcygeal line 179f
Pudendal nerve terminal motor latency time 181f
Pudendal neuropathy 181f
diagnosis of 181
Pulling rectum 188
Pulmonary disease 236
Pulmonary embolism 204
Pulmonary function test 251
Pulse oximeter 6
Puncture 99
Purge system 16
Purse string suture 174
Pyruvate kinase deficiency 109
Q
Quality control 13
Quality improvement 276
Quality-of-life, post-operative 164
Quaternary ammonium compound 10
R
Radially expanding trocar 63f
Radiation
safety 3
therapy 53
Radiofrequency ablation 135
Randomised control trials 62, 152, 204, 255
Recesses 178
Rectal cancer, laparoscopy in 154
Rectal internal mucosal prolapse, grading of 177f
Rectal prolapse 177, 182, 189
causes of 177
diagnosis of 178
types of 177, 177f
Recto-anal intussusception 180f
Rectocele 179f
Rectopexy 178, 186
anterior 182
Recto-rectal intussusception 179f
Rectovaginal septum 188
Rectum 187, 287f
Rectus abdominis muscle 240
Rectus muscles, lifting of 207f
Rectus sheath, posterior 208, 240, 242, 242f, 245f
Redo cholecystectomy 67
Reducible rectal prolapse 181
Redundant mucosa, excision of 184f
Reflux monitoring 129
Regional anaesthesia 48, 206
Regurgitation 128, 141
Rendezvous procedure 86
Rerineal recto-sigmoidectomy 183
Resection rectopexy, port placement for 186f
Respiratory therapy 11
equipment 15
Retention cyst 90
Retrograde ejaculation 160
Retroinfundibular window 71f
creation of 69
Retroperitoneal approach, posterior 121f
Retrorectal space 187f
Return electrode
contact quality monitoring 26
monitoring 26
Retzius cannula 206
Retzius’ space 196
Right adrenal
relations 122f
vein 123f
Right adrenalectomy 123
ports 123f
Right gland 122
Right hemicolectomy 157, 157f
Right iliac fossa 169, 171f
Right ureter, position of 157f
Ripstein procedure 182
Rives-Stoppa repair 240, 240f, 242
lateral limit of 242f
Robotic adrenalectomy 125
Robotic arms, triangulation of 299f
Robotic instruments 300f
Robotic platform for rectopexy 185
Robotic surgery 40, 298, 303
Robotic surgical systems 41
Robotic-assisted surgery 298
Role of Bougie 133
Rolling hiatus hernia 127, 127f
Round ligament 212, 287f
transection 292
Routine thromboembolic prophylaxis 204
Routine uncomplicated laparoscopic cholecystectomy 68
Roux-en-O configuration 270
Roux-en-Y cystojejunostomy 94
Roux-en-Y gastric bypass 80, 235, 250, 267, 268, 268f, 275277, 279
laparoscopic 136
port placement 269f
pouch, creation of 269
Wittgrove laparoscopic 268f
Roux-en-Y jejunal loop formation 93
Roux-en-Y limb, creation of 270
Roux-en-Y loop 93, 94
Rovsing's sign 169
S
Sacral promontory 187f, 188, 188f
peritoneal incision along 187f
Safe adrenalectomy 119
Safe anaesthesia 4
Safe cystogastrostomy 96
Safe laparoscopic
appendectomy 169
cholecystectomy 66
principles of 69
hysterectomy 285
splenectomy 107
Safe mini gastric bypass 279
Safe minimal access surgery, sterilisation for 10
Safe operation theatre, construction of 1
Safe rectopexy 177
Safe surgery saves lives 1, 4
Safe surgical teams 4
Safe veress needle insertion and stabilization, technique of 69f
Safest entry technique 61
Safety measures
post-operative 125
preoperative 119
Samson's artery 287
Scavenging system 46
Scavenging terminal outlets 2
Scoring system 169
Scrotal emphysema 198
Scrub nurse 2
Seasonal influenza vaccine 111
Sectorisation 37, 38f
Securing infundibulopelvic ligament 292
Self-fixating mesh 198
Semi-critical
devices, use of 14
instruments 13
Sensorial ergonomics 34, 41
Sensory substitution 40
Septic patient 218
Seroma 198, 217, 232
prevention of 232
treatment of 232
Serum
carcinoembryonic antigen 155
folic acid 251
ionised calcium 251
iron studies 251
parathyroid hormone 251
vitamin
B12 251
D3 251
Sexual dysfunction 160, 189, 200, 218
Sharp injuries, causes of 2
Sharp instruments, safety during use of 2
Shielded trocars 63f
Shoe-shine manoeuvre 134f
Short gastric, division of 133, 254f
Shoulder elevation 41
Sickle cell disease 109
Sigmoid colon 187
Sigmoid, detachment of 291
Silent intra-abdominal mesh infection 218
Silicon 26
non-split patient plate 26
split patient plate 26
Simple hepatic cysts 98
Simultaneous endoscopic sphincterotomy 81
Sine wave fashion 21
Single port laparoscopy 40
Single-incision laparoscopy 152
Situs inversus 67
Size of Bougie 256
Skin
grafts, abdominal 223
incision 5, 6
ulceration 237f
Sleep study 251
Sleeve gastrectomy 235, 250
Sliding hernia 213
Sliding hiatus hernia 127, 127f
Sling rectopexy, posterior 182
Small bowel, transection of 271f
Small cyst, single 99
Smoke 55
Society of American Gastrointestinal Endoscopic Surgeons 175
Solid organ transplant 66
Solid tumours, cavitations of 90
Solitary rectal ulcer 178
Somato-sensory-evoked potentials 181
Sophisticated energy sources 107
Space of Bogros 211, 212f
Space of Retzius 204
dissection of 216
Spaulding's classification 11, 14
scheme 12
Spermatic cord 193f
Spherocytosis, hereditary 109
Sphincter of Oddi 82
Spleen
surgical anatomy of 108f
visceral surface of 108f
Splenic abscess 109
Splenic artery 107, 114f, 115f
embolisation 112
pre-operative 107
ligation of 113
stump 113
Splenic flexure 114f
mobilisation of 114
Splenic hilum 112, 115f
Splenic infarction 109
Splenic ligament 108
Splenic marginal zone lymphoma 109
Splenic position 113f
Splenic sequestration crisis 109
Splenic torsion 117f
Splenic trauma 109, 110, 116
Splenic vein 107
thrombosis 109
Spleniculi, identification of 110
Splenocolic ligament, division of 114, 114f
Splenophrenic ligament, division of 114
Splenorenal ligament 109
posterior leaf of 115f
Sporicide 11
Squeeze pressure, maximum 180
S-shaped retracted 205
Standard laparoscopic surgical steps 155
Standard safe laparoscopic cholecystectomy 69
Standardised surgical steps 84
Staphylococcus 217
Staple line reinforcement 257, 258f
Stapled appendicectomy 173f
Stapled gastro-jejunostomy anastomosis, anterior wall of 273f
Stapled retrorectus repair 246f
Stapler
application 256
first firing of 281f
second firing of 281f
Steam sterilisation 14
Steel patient plate 26
Stent placement 85f
Sterile items, storage of 13
Sterile tissue 12
Sterilisation 10
indications for 13
methodology, modes of 14
Sterilisers, monitoring of 13
Steroid, chronic 160
Sterrad system 17
Stomach
dissection of 255
horizontal transection of 269f
proximal dissection of 255
Stomatocytosis, hereditary 110
Straight line principle 36
Strasberg's critical view of safety 71f
Stump appendicectomy 175
Stump appendicitis 175
Stump cholecystitis 67
S-type retractors 207
Subcutaneous onlay laparoscopic approach 246
Subumbilical incision 207
Subumbilical optical port 209
Subumbilical vision 209
Supra umbilical incision 59
Supracervical hysterectomy, laparoscopic-assisted 285
Suprapubic hernia 230
Suprapubic veress access 207
Surgeon positioning 206
Surgeon's posture 34, 36
Surgeon's technique 24
Surgery 53
consent for 5
indications for 130
site of 5
Surgery-related injuries 41
Surgical camera
and scope 302
head 302f
Surgical device 10
Surgical expertise available 45
Surgical Fire Prevention and Management Program 3
Surgical instruments 10, 13
Surgical procedure
fear of mortality and morbidity of 10
safety of 158
Surgical safety 1, 4, 7
Surgical services, measurement of 4
Surgical site infection 188, 236
prevention of 4
Surgical therapy, clinical outcomes of 153
Suture fixation 215
Suture rectopexy 186, 187
Symptomatic cholelithiasis 66
Symptomatic gall stone disease, treatment of 66
T
Technically speaking 22
Technique 186
Telescopic dissection 210
Tension-free anastomosis, splenic flexure mobilisation for 162f
Terminalis
inferior 107
superior 107
Testicular function 200
Theoretical rationale 12
Thiamine 284
Thoracic myotomy 146
Three-dimensional motion tracking 33
Thrombocytopenia 110
correction of 111
presence of 117
Thrombocytosis, post-operative 117
Thromboembolism 206
Thromboprophylaxis 159
Thrombotic thrombocytopenic purpura 109
Thyroid profile 251
Time limitations 8
Tissue expanders 238
Tokyo guidelines 73
Topical agents 199
Torres lesser curvature 268f
Total abdominal hysterectomy 285
Total cystectomy 98
Total extraperitoneal
approach 203, 245
repair 245f
Total intravenous anaesthesia 48
Total laparoscopic hysterectomy 285b, 286f, 289
contraindications for 285
Total mesorectal excision 154
Total pericystectomy 101
Totally extra-peritoneal approach 201
Toupet's 270° wrap 134
Trans-abdominal
approach 182
mobilization 182
pre-peritoneal 192, 193, 194f196f
placement of mesh in 197f
port positions for 195f
repair 203
rectopexy 182
resection 183
rectopexy 183
Trans-anal drainage 163
Transcystic exploration 84, 84f
Transected vertical pouch 270f
Transenterix robot 304f
Transfusion-dependent thalassaemia 109
Transhiatal oesophagectomy 149
Trans-jugular intrahepatic portosystemic shunt 260
Transversalis fascia 217
Transversus abdominis
block 48
division of 246f
lies, muscular belly of 243f
muscles 197, 243f
plane 49
release 242, 243, 243f
Transversus muscle fibres 243f
Trendelenburg position 118
Triangular vision 209, 209f
Triangulation technique 252
Triangulisation, concept of 39
Tricyclic antidepressant 182, 199
Trocar
insertion 69
inside sheath of 29
placement of 36, 39f, 225
type of 58b
True pancreatic cysts 90
T-tube drainage 82
Tuberculocide 11
Tumour
appendicular 173
necrosis factor alpha 104
Tunnelled vision 208
Tunnelling techniques 244
U
Ulnar deviation 35
Ultra-low particulate air 55
Ultrasonic cleaners 12
Ultrasonic dissectors 54
Ultrasonic energy 31, 171, 172
Ultrasonic scalpel 30, 31, 31t
system 30
Ultrasonography 239
abdomen 251
guided injection 238f
pelvis 251
Ultrasound 224, 268
Umbilical ligament 195
medial 192
Umbilical skin incision 216
Uncontrolled bleeding disorder 67
Undergo surgery 1
Unfractionated heparin 251, 283
Unilocular cyst 90, 92
Upper abdominal wall hernia 225, 226f
Upper chest surgery 4
Upper gastrointestinal endoscopy 142, 142f, 251
Upper limb muscles 68f
Upper short gastric, division of 254f
Ureteric injury 159, 292, 295
Urinary bladder 204
Urinary catheter, removal of 294
Urinary catheterisation 200, 204
Urinary complications 200
Urinary dysfunction 159, 189
Urinary retention 199, 200
post-operative 199, 204
Urine
pregnancy test 251
routine 251
Urogenital complications 159
Usher's use 192
Uterine bleeding, abnormal 285
Uterine fibroids, laparoscopic hysterectomy for 288
Uterine manipulator 290f
insertion of 289
Uterine vessel skeletonisation 291
Utero-ovarian ligament 287f
desiccation of 292f
Uterosacral ligament 287f, 288
Uterus
enlarged 285
laparoscopic view of 287f
premalignant lesions of 285
V
Vaginal cuff closure 294
Vaginal fornix, posterior 60
Vaginal hysterectomy, laparoscopic-assisted 285, 286f
Vaisey score 178
Vaporised tissue separates electrode 24
Vascular arcade, identification of 254f
Vascular injury 57, 62
incidence of 57
Vascular system 12
V-care uterine manipulator 290f
Venous thromboembolism 83, 117, 194
post-operative 111
prophylaxis 83, 111, 194
Venous thrombosis prophylaxis 186
Ventilation system 3
Ventral hernia 239, 247f
classification of primary 221
Ventral laparoscopic rectopexy 185
Ventral rectopexy 186, 188
Veress insertion, angle of 59, 59f
Veress needle 58f, 64
entry 64, 291f
insertion attempts and related complications of 60t
placement of 58
technique 252
Versaone™ fascial closure system 64
Vertical transection of Pouch 269f
Vessel injury 295
Vessel sealer 30
Virucide 11
Viscera and serious complications 200
Visceral injury, risk for 201
Visual analogue scale 48
Visualise inferior epigastric vessels 212f
Vitamin
A 284
D 284
deficiencies 279
Volatile liquids, hazards of 3
Volvulus 128
Vomiting
history of post-operative 49
post-operative 48, 49, 259
von Hippel Lindau disease 90
W
Walled-off pancreatic necrosis 89
Warm autoimmune haemolytic anaemia 109
Warning signs 163
Washer-disinfector 12
Washer-sterilisers 12
Waste
anaesthetic gases 46
disposal 2
Waveforms, effect of 24f
Weight bearing asymmetry 41
Wells procedure 182
Wheat germ agglutinin 129
White blood cell 169
Worker responsibilities 8
Working port's valve 54
World Health Organization 98
Wound-related symptoms 163
Wrong enterotomy closure 282f
Wrong placement 37
X
Xerocytosis, hereditary 110
Y
Yash scoring system 170
Z
Zinc 284
×
Chapter Notes

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