instruments – transcript

It is useful to understand the stack system used for laparoscopy so we can troubleshoot.

The medical grade printer is usually situated at the bottom. Most light sources are now LED based which reduces the need for frequent bulb changes.

This is a high definition digital camera and images and footage of procedures are stored in a digital capture storage device. The insufflator is shown with a carbon dioxide cylinder standing next to it. The instruments required for the so called bottom end are demonstrated here.

The Sims is used to expose the vagina. Always check the number of swabs routinely. Here, the swabs are mounted on sponge for preparing the abdomen and vagina with aqueous iodine. A single-tooth is used to hold the cervical lip. Some clinicians prefer a vulsellum which gives a more secure grip, but is also more traumatic.

This is a Spackman uterine manipulator with an adjustable mount which is later introduced into the uterus in order to antevert or retrovert the uterus. The tenaculum or vulsellum can be attached to the Spackman and this stabilises uterine manipulation. The uterine sound is used to measure the length of the uterine cavity and to check if the uterus is anteverted or retroverted. A simple in and out is used to empty the bladder prior to laparoscopy.

On the laparoscopy tray, we have the 10 mm laparoscope and the light lead which is later connected to the LED light source. The gas tubing is later connected between the insufflator and the Veress needle. The Veress needle is used for primary entry into the peritoneal cavity and for insufflation.

This is a 5 mm disposable , which has now replaced the metal autoclavable ones. Note the rubber guards to reduce likelihood of bowel injury. A 10 mm disposable trocar is often used for the umbilical cord.