Minimally Invasive and Laparoscopic Surgery

Lesson Objectives

By the end of this topic, learners should be able to:

1. Understand the principles of minimally invasive and laparoscopic surgery.

2. Identify common laparoscopic procedures and their indications.

3. Recognize post-operative complications and nursing priorities.

4. Apply perioperative care principles specific to minimally invasive surgery.

 Key Glossary Terms

1. Laparoscopy

• Definition: Surgical technique using small incisions and a camera (laparoscope) to perform surgery

• Indications: Gallbladder removal, appendectomy, hernia repair, gynecologic surgeries

• Advantages: Less pain, faster recovery, shorter hospital stay, minimal scarring

2. Robotic-Assisted Surgery

• Definition: Surgery performed using robotic instruments controlled by a surgeon

• Indications: Complex procedures such as prostatectomy, cardiac surgery, gynecologic surgery

• Benefits: Precision, reduced trauma, enhanced visualization

3. Pneumoperitoneum

• Definition: Insufflation of the abdominal cavity with CO₂ to create space for laparoscopic surgery

• Complications: Shoulder tip pain, gas embolism, increased intra-abdominal pressure

4. Trocar

• Definition: A sharp-pointed instrument used to access the abdominal cavity for laparoscopic instruments

• Complications: Injury to organs, bleeding

5. Common Laparoscopic Procedures

• Laparoscopic cholecystectomy (gallbladder removal)

• Laparoscopic appendectomy

• Laparoscopic inguinal hernia repair

• Laparoscopic colectomy

• Laparoscopic gynecologic procedures (ovarian cystectomy, hysterectomy)

6. Post-Operative Considerations

• Pain control, especially shoulder tip pain from CO₂

• Monitoring for bleeding, infection, organ injury

• Early ambulation to prevent DVT and ileus

• Wound care for small incision sites

7. Nursing & Medical Student Focus

• Nursing: Pre-op patient preparation, monitor vitals, educate about procedure, post-op pain management, observe for complications, early mobilization

• Medical Students: Understand indications, surgical steps, identify complications, evaluate post-op outcomes, interpret imaging when needed

8. Minimally Invasive Surgery Mnemonics

• “SCALP” for laparoscopy advantages:

  • Shorter hospital stay

  • Cosmetic benefit

  • Accurate visualization

  • Less pain

  • Precise surgery

• “GAS” for pneumoperitoneum complications:

  • Gas embolism

  • Abdominal pain / shoulder tip pain

  • Shock (rare severe complication)

 Tables

Table 1: Common Laparoscopic Procedures

Table 2: Post-Operative Nursing Care in Minimally Invasive Surgery