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0:00 Introduction
1:04 Why do doctors perform laparoscopy?
2:11 How is laparoscopy performed?
3:22 Result
3:47 Risk of laparoscopy
Laparoscopy (from Ancient Greek λαπάρα (lapára) 'flank, side', and σκοπέω (skopéō) 'to see') is an operation performed in the abdomen or pelvis using small incisions (usually 0.5–1.5 cm) with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few small cuts in the abdomen.[1]
Laparoscopic surgery, also called minimally invasive procedure, bandaid surgery, or keyhole surgery, is a modern surgical technique. There are a number of advantages to the patient with laparoscopic surgery versus an exploratory laparotomy. These include reduced pain due to smaller incisions, reduced hemorrhaging, and shorter recovery time. The key element is the use of a laparoscope, a long fiber optic cable system that allows viewing of the affected area by snaking the cable from a more distant, but more easily accessible location.
Laparoscopic surgery includes operations within the abdominal or pelvic cavities, whereas keyhole surgery performed on the thoracic or chest cavity is called thoracoscopic surgery. Specific surgical instruments used in laparoscopic surgery include obstetrical forceps, scissors, probes, dissectors, hooks, and retractors. Laparoscopic and thoracoscopic surgery belong to the broader field of endoscopy. The first laparoscopic procedure was performed by German surgeon Georg Kelling in 1901. There are two types of laparoscope:[2]
A telescopic rod lens system, usually connected to a video camera (single-chip or three-chip)
A digital laparoscope where a miniature digital video camera is placed at the end of the laparoscope, eliminating the rod lens system
The mechanism mentioned in the second type is mainly used to improve the image quality of flexible endoscopes, replacing conventional fiberscopes. Nevertheless, laparoscopes are rigid endoscopes. Rigidity is required in clinical practice. The rod-lens-based laparoscopes dominate overwhelmingly in practice, due to their fine optical resolution (50 µm typically, dependent on the aperture size used in the objective lens), and the image quality can be better than that of the digital camera if necessary. The second type of laparoscope is very rare in the laparoscope market and in hospitals.[citation needed]
Also attached is a fiber optic cable system connected to a "cold" light source (halogen or xenon) to illuminate the operative field, which is inserted through a 5 mm or 10 mm cannula or trocar. The abdomen is usually insufflated with carbon dioxide gas. This elevates the abdominal wall above the internal organs to create a working and viewing space. CO2 is used because it is common to the human body and can be absorbed by tissue and removed by the respiratory system. It is also non-flammable, which is important because electrosurgical devices are commonly used in laparoscopic procedures.[3]
Procedures
Surgeons perform laparoscopic stomach surgery.
Patient position
During the laparoscopic procedure, the position of the patient is either in Trendelenburg position or in reverse Trendelenburg. These positions have an effect on cardiopulmonary function. In Trendelenburg's position, there is an increased preload due to an increase in the venous return from lower extremities. This position results in cephalic shifting of the viscera, which accentuates the pressure on the diaphragm. In the case of reverse Trendelenburg position, pulmonary function tends to improve as there is a caudal shifting of viscera, which improves tidal volume by a decrease in the pressure on the diaphragm. This position also decreases the preload on the heart and causes a decrease in the venous return leading to hypotension. The pooling of blood in the lower extremities increases the stasis and predisposes the patient to develop deep vein thrombosis (DVT).[4]
Gallbladder
Rather than a minimum 20 cm incision as in traditional (open) cholecystectomy, four incisions of 0.5–1.0 cm, or more recently, a single incision of 1.5–2.0 cm,[5] will be sufficient to perform a laparoscopic removal of a gallbladder. Since the gallbladder is similar to a small balloon that stores and releases bile, it can usually be removed from the abdomen by suctioning out the bile and then removing the deflated gallbladder through the 1 cm incision at the patient's navel. The length of postoperative stay in the hospital is minimal, and same-day discharges are possible in cases of early morning procedures.[citation needed]
Colon and kidney
Transvenous cardiac pacing, also called endocardial pacing, is a potentially life saving intervention used primarily to correct profound bradycardia. It can be used to treat symptomatic bradycardias that do not respond to transcutaneous pacing or to drug therapy.
Buerger's disease (thromboangiitis obliterans) is a rare disease of the arteries and veins in the arms and legs. In Buerger's disease, your blood vessels become inflamed, swell and can become blocked with blood clots (thrombi). This eventually damages or destroys skin tissues and may lead to infection and gangrene. Buerger's disease usually first shows in your hands and feet and may eventually affect larger areas of your arms and legs. Virtually everyone diagnosed with Buerger's disease smokes cigarettes or uses other forms of tobacco, such as chewing tobacco. Quitting all forms of tobacco is the only way to stop Buerger's disease. For those who don't quit, amputation of all or part of a limb is sometimes necessary.
Learn about Bicuspid Aortic Valves in this presentation. Bicuspid Aortic Valves are present in about 2% of the population and are the most common congenital disorder. Find out more about a Bicuspid Aortic Valve by visiting the following link:
Cathy covers hemodialysis, including nursing care before, during, and after the procedure. Peritoneal dialysis, including nursing associated with the procedure. Key complications of hemodialysis, including disequilibrium syndrome and hypotension. Peritonitis, which is a key complication of peritoneal dialysis. Post-op nursing care and patient teaching associated with a kidney transplant.
Our Medical-Surgical video tutorial series is taught by Cathy Parkes BSN, RN, CWCN, PHN and intended to help RN and PN nursing students study for their nursing school exams, including the ATI, HESI and NCLEX.
#NCLEX #KidneyTransplant #HESI #Kaplan #ATI #NursingSchool #NursingStudent #Nurse #RN #PN #Education #LVN #LPN #Renal #Hemodialysis
0:00 What to Expect
0:31 Hemodialysis
2:06 Nursing Care
2:47 Peritoneal Dialysis
3:23 Nursing Care
4:09 Dialysis Complications
4:19 Disequilibrium Syndrome
4:55 Hypotension
5:26 Peritonitis
5:57 Kidney Transplant
6:17 Nursing Care
6:40 Signs and Symptoms
6:51 Patient Teaching
7:17 Quiz Time!
8:27 Bloopers
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All of the nurses at Level Up RN are here to help! Cathy Parkes started helping her fellow classmates back when she was in nursing school, tutoring so they could pass their exams and graduate. After she got her BSN and started working as an RN at Scripps Encinitas Hospital, she started this YouTube channel to help nursing students around the world. Since then she has built a team of top-notch dedicated nurses and nurse educators who are focused on improving nursing education and supporting career advancement for nurses everywhere. With flashcards, videos, courses, organizational tools and more, we are singularly focused on helping students and nurses Level Up on their exams and nursing careers.
Watch this video to learn how and when to change a dressing for a child with a hemodialysis catheter. You should change your child's dressing if it becomes soiled with water or blood or if it comes off at home. Keeping a clean dressing on your child will limit risk of infection.
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Rhode Island Hospital's outpatient dialysis program cares for patients with chronic kidney disease. Learn more about the program, which includes a new, state of the art dialysis center in East Providence. http://www.rhodeislandhospital.....org/outpatient-dial