Flashcards - Preventing Entry - Related Gynaecological Laparoscopic Injuries - Answers based on GTG 49 (version May 2008).

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Question 1

Rate of major complications with laparoscopic procedures is

Answer

1.4/1000

Question 2

Incidence of intestinal injuries with laparoscopic procedures is

Answer

0.6/1000

Question 3

Incidence of urological injuries with laparoscopic procedures is

Answer

0.3/1000

Question 4

Incidence of vascular injuries with laproscopic procedures is

Answer

0.1/1000

Question 5

A sharp Veress needle should be used for laparoscopic entry – True or False?

Answer

True (Sharp Veress needle with a good and tested spring action).

Question 6

At the start of laparoscopic procedure, the operating table should be ______.

Answer

Horizontal (not in Trendelenburg tilt).

Question 7

Veress needle should be inserted at ____ angle to the skin.

Answer

right

Question 8

Two audible clicks are heard when ____ and ______ are penetrated with Veress needle.

Answer

Fascia and peritoneum.

Question 9

Intra-abdominal pressure before inserting primary trocar should be ______.

Answer

20 – 25 mmHg.

Question 10

Distension pressure should be reduced to _____ once the insertion of the trocars is complete.

Answer

12-15 mmHg.

Question 11

What should be done if there is a concern that bowel may be adherent under the umbilicus after the trocar entry?

Answer

Primary trocar site visualised from a secondary port.

Question 12

On completion of procedure, visual control during removal of laparoscope should be used to check that there has not been a ___.

Answer

Through – and – through injury of the bowel adherent under the umbilicus.

Question 13

With Hassan open laparoscopic entry, before inserting blunt tipped cannula it should be confirmed that ____

Answer

Peritoneum has opened by visualising the peritoneum.

Question 14

Palmer’s point should not be used when

Answer

H/o prev surgery in that area or splenomegaly

Question 15

Rate of adhesion formation at the umbilicus following midline laparotomy is __

Answer

50%

Question 16

Rate of adhesion formation at the umbilicus following low transverse incision is ____.

Answer

23%

Question 17

Palmer’s point is ____ cm below the left costal margin in the midclavicular line.

Answer

3 cm

Question 18

Secondary ports must be inserted under direct vision perpendicular to the skin, when pneumoperitoneum is maintained at ___.

Answer

20 – 25 mmHg.

Question 19

Which vessels should be visualised before secondary port insertion?

Answer

Inferior Epigastric vessels

Question 20

Deep epigastric vessels can be visualised just lateral to the _______.

Answer

Two audible clicks are heard when and __ are penetrated with Veress needle.