Pelvic laparoscopy has undergone massive
changes in terms of instrumentation and techniques, which has made it a popular
procedure over laparotomy. The technique is known to offer better visualisation of the
pelvic viscera. The patient’s arms are placed at the side for the surgeon to
have easy access after the induction of general anaesthesia.
Anaesthetic technique
According to Dr. Rowan Molnar, a Staff Specialist
Anaesthetist Launceston General Hospital, Tasmania, Australia it is essential
for the anaesthetic technique used in laparoscopy to compensate for
physiological disturbances. Premedication is decided on by the anaesthetist and
is used to reduce any anxiety felt by the patient. An intravenous cannula is
introduced in the hand or forearm vein with an extension attached to the tubing
for easy introduction of injections. Induction is performed with anaesthetics
where the tip of a short cuffed tube is secured beyond the larynx. The
anaesthetist uses agents such as nitrous oxide and oxygen anaesthesia which is
supplemented with short acting narcotic analgesics to induce muscle relaxation.
In pelvic laparoscopy, ventilation is
controlled by a respirometer which monitors tidal and minute volumes, and is
used to adjust ventilation. Following the administration of anaesthesia, the
patient’s legs are secured on stirrups and the feet dropped off the table.
After the procedure, patients require to spend time in the recovery area until
the effects of anaesthesia wear off. Outpatients are usually discharged the
same day as the procedure depending on the type of anaesthesia given once vital
signs such as blood pressure, pulse and breathing are stable.
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