port position in mas - world laparoscopy hospital...port position in mas r. k. mishra . 2 2 ......

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

Port Position in MAS

R. K. Mishra

2 2


Where Should I

Put my Port?

3 3


Statistics

The most

common

cause of

stressful

surgery is

wrong port

position

4 4


Is Umbilicus Safe For Primary

Port ?

•Wound infection at the

umbilicus is similar to

that at other sites

•Postoperative ventral

hernia at the umbilicus

is similar to that at other

sites

The central location and ability of the umbilicus to camouflage scars make it an

attractive primary trocar site for laparoscopic surgery.

5 5


For Operative Surgery Follow

Base Ball Diamond Concept

6 6


First Decide the Target

7 7


Find The Length Of Your

Instrument

Size of Adult Laparoscopic Instrument is

36 Cm & Paediatrics Instrument is 28 cm

For optimum task

performance the

half to two third

instrument should

be inside the

abdomen

8 8


18 cm

24 cm

Draw The Line Of Optimum

Area

Draw two arcs on

the abdominal wall

at 18 and 24 cm

from that point and

note the area in

between

9 9


Telescope & Instruments

1.Telescope should

be in the middle of

instruments

2.Manipulation angle

of instruments

should be 60

degree

10 10


“Baseball Diamond” Concept

11 11


Rule Of Diamond

18 cm

24 cm

12 12


Rule Of Diamond

13 13


Laparoscopic Appendectomy

14 14


Laparoscopic Hernia

15 15


Drawing with Surgical Sketch

16 16


“Baseball Diamond” concept

17 17


Splenectomy

“Baseball Diamond” concept

18 18


If There Are Two Targets ?

That part of the abdominal wall which is common to the two areas marked is

the best site for the ports.

19 19


Rule of

Diamond

Not

Always

Applicable

Retroperitoneoscopy

20 20


Rule Not Applicable Always

21 21


Hemi-Nephroureterectomy

22 22


Thank you

Our Advance course at Iranian Hospital, Dubai

port position in mas - world laparoscopy hospital...port position in mas r. k. mishra . 2 2 ......

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