Fig. 1.1
Equipment and patient position during hiatal hernia
Specific surgical drapes are used.
Laparotomic Instrument Table Must Be Always Ready for Use
Surgical Steps
1.
Hernia reduction
2.
Anatomical landmark recognition
3.
Pars flaccida opening
4.
Short gastric vessel ligation
5.
Retroesophageal tunneling
6.
Hiatoplasty
7.
Fundusplication
Instruments and Cables
30, 5, or 10 mm laparoscope
Cold light source cable
CO2 pipe and filter
Monopolar electrocautery
Patient return electrode (REM)
Sterile instrument bag
Monopolar and bipolar electrocautery cables
Ultrasonic dissector/radiofrequency cables
Bladder catheterization set
56 Fr Maloney probe
Laparoscopic Instrument Table (Fig. 1.2)
Sutures: 2-0 braided not absorbable suture, 0 braided absorbable suture, and skin wound closure sutures
Surgical scalpel blade No. 23
Laparoscopic gauzes
Stainless surgical bowl
Gross-Maier dressing forceps
Two Bernhard towel forceps
Veress needle and 10 mL syringe
Three 10–12 mm trocars
Two 5 mm trocars
Needle holder
Two tissue forceps with teeth
Anatomical thumb forceps
Metzenbaum scissors
Mayo scissors
Two Klemmer forceps
Two Kocher forceps
Two Backhaus forceps
Two Farabeuf retractors
Bipolar laparoscopic forceps
Ultrasonic dissector/radiofrequency dissector
Laparoscopic scissors
Laparoscopic needle holder (2–0, 10 cm long, not absorbable braided must be ready on the instrument)
5–10 mm Endo Retract
5–10 mm clip applier
Johann forceps without ratchet handle
Johann forceps with ratchet handle
42 cm long Johann forceps without ratchet handle
Thermos
Fig. 1.2
Instrument table
1.2 Lower Esophagus Neoplastic Diseases
The bed is placed in reverse Trendelenburg position with left tilt. First operator stands between patient’s legs. Laparoscopic rack is placed behind patient’s head (Fig. 1.3a–d).
Specific surgical drapes are used.
Laparotomic Instrument Table Must Be Always Ready for Use
Surgical Steps
1.
Anatomical landmark recognition
2.
Esophageal hiatus isolation
3.
Posterior mediastinum access
4.
Esophageal dissection and lymphadenectomy
5.
Azygos vein section (if needed)
6.
Gastric tubulization
7.
Kocher’s maneuver
8.
Cervicotomy or right thoracotomy (if needed)
9.
Specimen extraction
10.
Anastomosis
Fig. 1.3
(a–d) Equipment and patient position during esophagectomy
Instruments and Cables
30, 5, or 10 mm laparoscope
Cold light source cable
CO2 pipe and filter
Monopolar electrocautery
Patient return electrode (REM)
Sterile instrument bag
Bipolar forceps for open surgery
Monopolar and bipolar electrocautery cables
Ultrasonic dissector/radiofrequency cables
Ultrasonic dissector/radiofrequency dissector with bariatric handle and cablesRelated posts:
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