1, artificial pneumoperitoneum
Cut the skin 1cm at the lower edge of the umbilical wheel, insert the pneumoperitoneum at 45 degrees from the incision, and draw a bloodless tube after the pumping. If the saline flow smoothly, the puncture is successful and the needle is in the abdominal cavity. Connected to the CO2 inflator, the intake speed does not exceed 1L/min, and the total amount is 2-3L. The intra-abdominal pressure does not exceed 2.13 KPa (16 mmHg).
2, trocar puncture
Laparoscopy needs to be inserted into the abdominal cavity from the cannula, so the trocar must be inserted first. The laparoscopic cannula is thicker and the incision should be 1.5 cm. Lift the ventral wall of the umbilicus, insert the trocar first obliquely and then slowly insert it into the abdominal cavity. When entering the abdominal cavity, there is a sense of breakthrough. Pull out the ferrule core, insert the laparoscope after hearing the gas in the abdominal cavity, turn on the light source, adjust the patient. The posture is 15 degrees lower than the hip height and continues to inflate slowly.
3, laparoscopic observation
The surgeon held a laparoscope and observed the uterus and various ligaments, ovaries and fallopian tubes, and rectal uterus. When observing, the assistant can move the uterus device and change the position of the uterus to check. If necessary, suspicious lesion tissue can be taken for pathological examination.
4, take out the laparoscope
Check for no internal bleeding and organ damage before taking out the laparoscope, removing the gas in the abdominal cavity, removing the cannula, suturing the abdominal incision, covering with sterile gauze and tape.
5, after laparoscopy treatment:
(1) Antibiotics should be given to prevent infection;
(2) Although the venting before the abdominal incision has been exhausted, the abdominal cavity may still have residual gas and feel shoulder pain and upper abdominal discomfort, which is usually not serious and requires no special treatment.