Endoscopic and Minimally Invasive Instrumentation
Endoscopy is a minimally invasive procedure where a small lumen, typically a flexible endoscope with a lens and light source, is inserted into the body to clearly show a cavity or structure for therapeutic or diagnostic purposes. Diagnostic endoscopy such as upper and lower gastrointestinal gastroscopy and colonoscopy, and bronchial/lung visualization, typically takes place in an endoscopy suite. Other areas where minimally invasive diagnostics and procedures take place are cardiac catheterization labs and radiology departments. Although these areas are usually staffed with specifically trained nurses and technicians, the operating room also performs various endoscopic procedures that perioperative nurses must learn.
(Cromb, 2019)
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Endoscopic and Minimally Invasive Instrumentation
When scopes are used inside the abdominal cavity, there is internal anatomy that must be considered for safety purposes. Although nurses are not performing surgery, they must have a thorough knowledge of anatomy to anticipate untoward events.
See the image example. For a Laparoscopic Cholecystectomy, the surgical team needs to be able to visualize the gallbladder under the liver without injuring any of the abdominal organs.
For all laparoscopic procedures, basic instruments are required to make incisions, insufflate the abdomen, and close the incision postoperatively. Perioperative nurses set up both a minor ‘opening/closing’ set as well as a laparoscopic set. Because laparoscopic procedures may need to be converted to open incisions, ORNAC standards (2021) recommend a full count of instrumentation at the outset of surgery.
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- Minimally Invasive Surgery