Image Based Discussion On Laproscopic, Diathermy Or Electrosurgery

Diathermy Or Electrosurgery

Monopolar diathermy 

 It has a single active electrode . M/C used for surgeries It has an active cable and a return cable→ From active cable alternating current goes to active electrode.  Active electrode has small surface area→ When alternating current reaches small surface area of active electrode the electric current is concentrated producing heat which is used for cutting and coagulation . Blue button →Coagulation . Yellow button →Cutting  Via return electrode alternating current goes to return cable and then to electro-surgical unit.

Bipolar diathermy 

It has 2 active electrodes o Advantage → Surrounding tissue is free from the risk of being burned or having current pass through them .Used in Gynecological surgery.

Effects of diathermy · Coagulation: Activated by intermittent waveform · Cutting : Activated by constant waveform · Fulguration : Destructive coagulation + Charring · Blended wave form: Advantage of having both cutting and coagulation

Capacitance Coupling aka Capacitive Coupling

It is having relatively thin insulation layer. · High frequency alternating current is used · Current from active electrode is transmitted to nearby conductor where if any viscera comes in contact result in stray current injury k/a Capacitance coupling. If conductors metallic port is replaced by plastic port, this injury can be avoided.

Given instrument is Ligasure 

It is electrothermal bipolar tissue sealing system · Used in Laparoscopic abdominal and pelvic surgeries to seal the vessels upto 7 mm in diameter · Uses - Seal the vessels →Upto 7 mm within 2 to 4 seconds, Also seal pedicles of organ, tissue bundles and lymphatics · Advantage - Improves vessel sealing with Minimal lateral thermal spread.

Hormonic Scalpel 

It is based on ultrasound technology · It uses USG to cut tissue and seal them · The scalpel vibrates at frequency of 20,000 to 50,000 Hz causing denaturation of proteins · It can divide both artery and veins upto 7 mm · Advantage - Less thermal damage to adjacent tissue . Less charring and dessication o Reduced operative me o Faster recovery.

Also Read: Image Based Questions On Clamps

LAPROSCOPIC INSTRUMENTS

Veres Needle 

It is used to create pneumoperitoneum by closed method · Sharp tipped needle with blunt p obturator · Sharp tipped needle penetrates the abdominal wall→ Resistance is lost · Blunt tipped obturator springs forward to prevent any iatrogenic injury · Intraperitoneal position of veres needle is checked by Saline drop test . Attach a syringe with saline to the veres needle and aspiration is done→ Then remove the plunger and observe the free flow of saline into peritoneal cavity . This confirms location of needle in peritoneal cavity.

Also Read: Image Based Questions On Forceps

Hassons Cannula 

It is used to create pneumoperitoneum by open method · Used in o Patients who are having previous history of upper abdominal surgery . If patient is having ileus · Advantage →Less chances of vascular injury.

Yankauer Suction Cannula 

It has blunt smooth rounded tip having 3 holes (2 side hole and 1 main hole) · It has an angulated body→ It does not obstruct surgeons field of vision · Used in surgeries where large volume of fluid has to be sucked like in Peritoneal lavage (it is generally performed in perforation peritonitis and hemoperitoneum).

Adson's suction cannula 

It is having a vent with thumb rest which gives beer control of suction cannula · It is having slight angulation and fine suction tip · Used for fine and meticulous surgery like plastic surgery, reconstructive surgery and vascular surgery.

Also Read: Most Commonly Used Surgical Instruments

Hope you found this blog helpful for your NEET SS General Surgery preparation. For more informative and interesting posts like these, keep reading PrepLadder’s blogs.