Laparoscopicdissectiontechniques-WorldLaparoscopy.docVIP

WORLD LAPAROSCOPY HOSPITALCyberciti, DLF Phase II, NCR Delhi, Gurgaon, 122 002, India Phone: +91(0)12-Mobile: +91(0)9811416838, 9811912768, Email: contact@ Click here for training detail Laparoscopic dissection techniques Dissection is defined as the separation of tissues with haemostasis. It consists of a sensory (visual and tactile elements) component and an access component involving tissue manipulation and instrument maneuverability. These are combined to achieve exposure i.e. developing a suitable space for seeing and handling target structures/ ? Precision and meticulous haemostasis is essential requirements in minimal access surgery. Endoscopic dissection, in contrast to dissection in conventional surgery, possesses several limitations. Three- dimensional direct vision is replaced by two dimensional indirect visions in laparoscopic surgery. Illumination and the video image quality are still limited despite recent advances in video systems such as digitization and 3-chip endocamera. Movement of the functional tip of laparoscopic instruments is restricted along with the kinematics response. The loss of tactile sensation in endoscopic surgery is yet another limiting factor ? A variety of mechanisms have been used to divide tissue and enable haemostasis. They all involve some form of physical energy being applied to the appropriate tissue. The amount of energy required for dissection depends on the type and constituency of the tissue. The properties of tissues may vary in different directions and for different disease states. This in totality influences the choice of the modality for dissection. ? The ideal dissection technique requires a modality that can accomplish meticulous haemostasis and will be tissue selective without causing inadvertent tissue damage. It must be safe for both patient and surgical team when in regular use and when inactive in storage. In this respect built-in safety measures are mandatory. An ideal dissecting modality should b