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  • Port Position in Laparoscopic Surgery

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    The document discusses port placement and positioning for laparoscopic surgery. It recommends using the "baseball diamond" concept, which involves placing ports within an optimal area between 18-24 cm from the surgical target based on the length of instruments. The primary port is often placed at the umbilicus as it provides central location and camouflages scars well. However, port placement must be tailored to the specific surgery and anatomy, and the rules may not always apply, such as for retroperitoneal procedures. Proper port positioning is important for operative efficiency and ergonomics.

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    The document discusses port placement and positioning for laparoscopic surgery. It recommends using the "baseball diamond" concept, which involves placing ports within an optimal area between 18-24 cm from the surgical target based on the length of instruments. The primary port is often placed at the umbilicus as it provides central location and camouflages scars well. However, port placement must be tailored to the specific surgery and anatomy, and the rules may not always apply, such as for retroperitoneal procedures. Proper port positioning is important for operative efficiency and ergonomics.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    3 views22 pages

    Port Position in Laparoscopic Surgery

    Uploaded by

    Јован Петровић
    The document discusses port placement and positioning for laparoscopic surgery. It recommends using the "baseball diamond" concept, which involves placing ports within an optimal area between 18-24 cm from the surgical target based on the length of instruments. The primary port is often placed at the umbilicus as it provides central location and camouflages scars well. However, port placement must be tailored to the specific surgery and anatomy, and the rules may not always apply, such as for retroperitoneal procedures. Proper port positioning is important for operative efficiency and ergonomics.

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    © All Rights Reserved
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    of 22

    Port Position in MAS

    R. K. Mishra
    World Laparoscopy Hospital Essentials of Laparoscopic Surgery
    Where Should I
    Put my Port?

    World Laparoscopy Hospital Essentials of Laparoscopic Surgery 2 2


    Statistics

    The most
    common
    cause of
    stressful
    surgery is
    wrong port
    position
    World Laparoscopy Hospital Essentials of Laparoscopic Surgery 3 3
    Is Umbilicus Safe For Primary
    Port ?

    •Wound infection at the


    umbilicus is similar to
    that at other sites

    •Postoperative ventral
    hernia at the umbilicus
    is similar to that at other
    sites

    The central location and ability of the umbilicus to camouflage scars make it an
    attractive primary trocar site for laparoscopic surgery.

    World Laparoscopy Hospital Essentials of Laparoscopic Surgery 4 4


    For Operative Surgery Follow
    Base Ball Diamond Concept

    World Laparoscopy Hospital Essentials of Laparoscopic Surgery 5 5


    First Decide the Target

    World Laparoscopy Hospital Essentials of Laparoscopic Surgery 6 6


    Find The Length Of Your
    Instrument

    For optimum task


    performance the
    half to two third
    instrument should
    be inside the
    abdomen

    Size of Adult Laparoscopic Instrument is


    36 Cm & Paediatrics Instrument is 28 cm

    World Laparoscopy Hospital Essentials of Laparoscopic Surgery 7 7


    Draw The Line Of Optimum
    Area

    Draw two arcs on


    the abdominal wall
    at 18 and 24 cm
    from that point and
    note the area in
    between 24 cm

    18 cm

    World Laparoscopy Hospital Essentials of Laparoscopic Surgery 8 8


    Telescope & Instruments

    1. Telescope should
    be in the middle of
    instruments
    2. Manipulation angle
    of instruments
    should be 60
    degree

    World Laparoscopy Hospital Essentials of Laparoscopic Surgery 9 9


    “Baseball Diamond” Concept

    World Laparoscopy Hospital Essentials of Laparoscopic Surgery 10 10


    Rule Of Diamond

    24 cm

    18 cm

    World Laparoscopy Hospital Essentials of Laparoscopic Surgery 11 11


    Rule Of Diamond

    World Laparoscopy Hospital Essentials of Laparoscopic Surgery 12 12


    Laparoscopic Appendectomy

    World Laparoscopy Hospital Essentials of Laparoscopic Surgery 13 13


    Laparoscopic Hernia

    World Laparoscopy Hospital Essentials of Laparoscopic Surgery 14 14


    Drawing with Surgical Sketch

    World Laparoscopy Hospital Essentials of Laparoscopic Surgery 15 15


    “Baseball Diamond” concept
    World Laparoscopy Hospital Essentials of Laparoscopic Surgery 16 16
    Splenectomy
    “Baseball Diamond” concept

    World Laparoscopy Hospital Essentials of Laparoscopic Surgery 17 17


    If There Are Two Targets ?

    That part of the abdominal wall which is common to the two areas marked is
    the best site for the ports.

    World Laparoscopy Hospital Essentials of Laparoscopic Surgery 18 18


    Rule of
    Diamond
    Not
    Always
    Applicable

    Retroperitoneoscopy
    World Laparoscopy Hospital Essentials of Laparoscopic Surgery 19 19
    Rule Not Applicable Always

    World Laparoscopy Hospital Essentials of Laparoscopic Surgery 20 20


    Hemi-Nephroureterectomy

    World Laparoscopy Hospital Essentials of Laparoscopic Surgery 21 21


    Thank you

    Our Advance course at Iranian Hospital, Dubai

    World Laparoscopy Hospital Essentials of Laparoscopic Surgery 22 22

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