Laparoscopic Instrumentation(腹腔镜手术器械).pdfVIP

Laparoscopic Instrumentation Patrick S. Lowry INTRODUCTION Laparoscopic instrumentation continues to evolve towards smaller, more reliable, and better ergonomic devices, with a larger variety of choices. Since the first edition of this textbook, subtle improvements are readily apparent in existing devices as first-generation instruments progress towards later-generation models. New technology exists to allow procedures to be performed with fewer com- plications. Combined with refinements in techniques, new and improved instrumentation provides urologic surgeons the opportunity to safely perform more challenging procedures by a laparoscopic approach. CAMERA SYSTEMS Camera systems still have three integral parts: the camera head, the camera system control unit, and the monitor. These systems have progressed from analog to digital to advanced applications of digital technology (1). Most cameras attach to the end of the scope to capture the image coming through the lens. This image is then captured as a digital signal and transferred by the control unit to the monitor. Newer monitors are flat screen panels. Early flat screens did not provide adequate imaging, but by increasing pixel concentration and subsequently progressing into high-definition (HD) imaging, current monitors surpass previously available picture quality. To achieve this, significant improvement was required in the transfer of the digital signal to the monitor. Early-generation digital units suffered from a millisec- ond lag time between what was performed surgically and what was seen on the screen. This delay can be distracting, due to the subtle disconnect between surgeon and image. The current units process the signal to an image with increased speed, making any delay imperceptible. Some systems, videolaparoscopes, employ a single camer