Laparoscopy technology has been widely used in many hospitals, covering almost all surgical fields. In the application, some problems will inevitably occur, which will affect the operation. Laparoscopic surgery is inseparable from the endoscopic camera system, C02 pneumoperitoneum, light source system, multi-functional single and bipolar high-frequency electrosurgical system and operating instruments. No matter which part of the problem occurs, it will affect the process of the operation and even cause the operation to fail. . Let's learn about the common problems and solutions of laparoscopy.
Common problems and treatment of endoscopic camera system
The endoscopic camera system is the eye of a laparoscope. Common problems include blurred lenses and unclear images. The reason is that there is fog on the camera lens or the focus adjustment is inaccurate. The way to distinguish is to carefully check the fine parts of the subject, whether the edges of blood vessels or organs are clear. If the edges are sharp, the lens should be foggy, which can be at the front of the optical tube. Apply anti-fog oil or soak the lens in hot water at about 50℃ for a while, then insert the lens into the abdominal cavity and continue using it. You can also rinse the light source test tube with water. The front end effect is also very good. If the above method is not ideal, it may be The connection between the camera lens and the light source test tube is foggy, disconnect the connection and wipe it with an alcohol cotton ball and then reconnect it; if the edge is blurred because the focus is not adjusted correctly, you need to re-adjust the focus; if the image color is distorted, blue or red The reason is that the self-balance adjustment is inaccurate, and the solution is to re-adjust the white balance.
Common problems with pneumoperitoneum
1. Pneumo-abdominal muscle air source pressure knife alarm
If the air source pressure is insufficient or out of air, the air source pressure alarms, just replace the air source or open the air source valve; if the alarm still exists after eliminating the above reasons, check whether the high pressure air pipe is blocked or discounted.
2. The small abdominal pressure knife machine shows that the actual pressure in the abdominal cavity is too high
The reason may be that the pneumoperitoneum needle did not enter the abdominal cavity during puncture, or the puncture entered the greater omentum, or the tip of the pneumoperitoneum needle touched the abdominal wall. At this time, after turning on the pneumoperitoneum machine, the instant flow rate on the machine is slower than normal. The actual flow rate The display is very small, not reaching the usual flow rate and the actual pressure in the abdominal cavity is rapidly rising or high. The treatment method is to re-puncture or adjust the position of the insufficiency needle, connect a syringe with water and no needle plug to the insufflation needle, and see The smooth flow of water proves that the puncture is successful, just connect the pneumoperitoneum tube. If the above situation continues after connecting, you need to check whether the low-pressure pneumoperitoneum tube is discounted or blocked.
Light source system problem
If the entire field of view is dark, it may be that the light source is too dark. Adjust the brightness of the light source. If it is still abnormal, check the light guide. The method is to remove the light guide, slowly move from the dark place to the bright place, observe whether the cross section at the other end changes from dark to bright, and observe the number of black spots at the cross section, and the black on the cross section when facing a bright place If the dot exceeds 20%～30%, you need to replace the light guide fiber. If the image of the entire screen is black, check whether the connection of the entire light source system is normal, or check whether the brightness of the light source bulb is normal and whether the cooling fan is rotating; if it is The electronic mirror that automatically adjusts the brightness should also check whether the RGB cable connected between the light source and the camera system is normal.
Common problems of multifunctional single and double pole high frequency electrosurgical unit and instrument system
The common problems of single and bipolar high-frequency electrosurgical units are whether the output/output power is too small/the output end is adhered to tissue bleeding; the common cause of no output is that the connection line is broken or the negative plate is not connected; if the output power is too small, check The set power of the machine, do not blindly increase the output power. If the set power is not much different from the power used in normal times, it may be a virtual connection of the connection line. At this time, move the connection line, especially near the two ends of the line. ; If there is bleeding in the adhesive tissue at the output end, check whether there is a blood clot or eschar at the front end, if it is cleaned up, if not, the output power setting is too small; when the above problems occur, it may sometimes be the cause of the operation of the instrument , The treatment method is to use or replace the operating equipment after disassembling the equipment and reassembling. If the above methods still cannot be solved, please ask the equipment maintenance personnel to deal with it.
The above briefly introduces the common problems and treatment methods in laparoscopic surgery. If there is a problem during use, do not panic. Find the cause of the problem and solve it easily. If you really don't know how to solve it, you must contact the manufacturer and do not remove it yourself.