Principles of finding the entry site in laparoscopic surgery

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1. The main principles for choosing a trocar . position

Ideal trocar placement when the following criteria are met:
1.1. The view direction of the scope and tools when operating The two main operating tools and the scope should form 60 degrees, where the camera is between the two tools (triangle principle) and the direction of the two tools. The main operation must conform to the abdominal wall at an angle of 60 degrees (operating angle). This ideal 60-degree angle can be achieved by a combination of the proper position of the trocar hole and the tilt adjustment of the operating table, as well as the angle between the surgeon's arm and shoulder.
The direction of view of the scope should be placed perpendicular to the operating plane of the target organ (angle of view). At a 90-degree viewing angle, it will give the best image, the surgeon's sense of space is also the most accurate. As a result, surgery time will be reduced and complications will also be reduced.
The placement of the trocar holes meets the requirements of the viewing direction and the instrument will help the surgeon feel comfortable when operating. Manipulations will be easier and more precise (surgery is clearer). Today, creating a surgical field is easier thanks to 30- and 45-degree scopes, but it requires the skill of the bronchoscope operator to be good.
In addition, the angle between the handle and the body of the needle carrier is also very important, affecting the operation of the surgeon. Classical needle-carrying tools are typically 0 degrees. Recent studies show that this angle of 40 degrees will help optimize the operation of the surgeon.

1.2. The distance between the endoscope and the target organ and the length of the instrument The distance from the end of the scope to the target organ plays an important role in helping the surgeon to see the surgical field more clearly. If this distance is closer or farther away, it will magnify or reduce the surgical field too much. This will affect the surgical process. In addition, the ratio between the length of the instrument inside the abdomen and the part outside the abdomen will also significantly affect the operation of the surgeon. Thus, the appropriate position of trocar placement is that when the instrument is put into operation, the extra-abdominal part of the instrument is no longer than the intra-abdominal part.
1.3 Other factors The placement of the trocar is also influenced by other factors such as:
Patient's position during surgery. Position of primary and secondary surgeons. Body of the surgeon.

2. Applying laparoscopic surgery for appendicitis

Appendicitis is an acute disease with diverse clinical symptoms. If the disease is diagnosed and treated early, the mortality rate is very low. Today, laparoscopic surgery is the optimal method of choice for most doctors to treat this disease, because this method helps patients quickly recover and significantly reduce complications. This surgical procedure can be done through 3 trocar holes, 2 trocar holes or 1 umbilical trocar hole.

Surgery to remove appendix through a trocar hole is the most interested doctor, because this method is not too complicated. However, to perform this method requires a doctor who is experienced in laparoscopic surgery. The location of trocar placement in appendicitis surgery of this method is just below the navel.
The advantages of this method are that it helps patients less pain after surgery because there is only a small incision under the skin, less complications as well as infection due to trocar placement. However, this method requires laparoscopic appendix surgery tools to be specialized and qualified, so patients should choose reputable and well-qualified addresses to perform this surgery.
Vinmec International General Hospital is a general hospital with the function of examining, treating and recovering many diseases with modern standard medical equipment, and technical equipment is also invested in innovation. suitable for each different surgery in order to minimize dangerous complications that may occur during and after completion. Especially with a team of highly qualified and well-trained doctors and nurses, they will bring optimal treatment results to customers.
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