Fig. 6.1
(a, b) Equipment and patient position during splenectomy
Specific surgical drapes are used.
Laparotomic Instrument Table Must Be Always Ready for Use
Surgical Steps
1.
Landmark recognition
2.
Left colic angle mobilization
3.
Short gastric vessel section
4.
Isolation and clip application on splenic artery
5.
Isolation and section of splenic vessels
6.
Clip removal
7.
Splenectomy
8.
Specimen extraction on Pfannensteil incision
Instruments and Cables
30 and 5/10 mm laparoscope
Cold light source cable
CO2 pipe and filter
Monopolar electrocautery
Patient return electrode (REM)
Sterile instrument bags
Bipolar laparotomic forceps
Monopolar and bipolar electrocautery cables
Ultrasonic dissector/radiofrequency cables
Irrigation/suction laparoscopic device
Bladder catheterization set
Fig. 6.2
Laparoscopic instrument table
Sutures: 2-0 absorbable braided suture and skin wound closure sutures
Surgical scalpel blade No. 23
Gauzes
Laparoscopic gauzes
Stainless surgical bowl
Gross-Maier dressing forceps
Two Bernhard towel forceps
Veress needle and 10 mL syringe
Two/three 10/12 mm trocars
One/two 5 mm trocars
Needle holder
Two tissue forceps with teeth
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 clip applier
Two Johann forceps without ratchet handle
56 cm long Johan forceps without ratchet handle
Endo GIA 45 mm (vascular cartridge)
Laparoscopic 90° forceps with rounded tip
15 mm Endobag
Thermos
Fig. 6.3
Laparoscopic instrument table
6.2 Pancreatectomy
The bed is placed in reverse Trendelenburg position. First operator stands between patient’s legs. Laparoscopic rack is placed behind patient’s head (Fig. 6.4).
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