WITH ANSWERS 100% CORRECT
◉ What degree scope is best for a field of view in-line with a port?
Answer: Zero degree
◉ What is the most commonly used light source? Answer: 300 W Xenon
lamp
◉ What if there is initial low pressure and high flow rate at entry?
Answer: There may be a leak in the insufflator circuit. Check all
connections.
◉ Benefits of Monopolar energy. Answer: Tissue heated quickly. Less
thermal spread/coagulation.
◉ Monopolar voltage/frequency Answer: Low voltage, High frequency
◉ What does coagulation mode do? Answer: Rapid surface heating with
shallow depth of necrosis. intermittent wave form with higher voltage.
,◉ What are some risks of monopolar energy? Answer: Current can be
diverted through unintentional pathways leading to inadvertent tissue
injury. To avoid this, do not use "hybrid" ports that mix plastic with
metal.
◉ How does a grounding pad avoid injury with monopolar energy?
Answer: Grounding pads help avoid capacitative coupling. This happens
when two conductors are separated by an insulator and the passive
electrode stores energy that can be released with tissue injury. The
grounding pad inhibits the passive electrode from storing energy.
◉ Benefits of bipolar energy. Answer: - Lower risk of inadvertent injury.
- Produces less thermal spread and necrosis.
- No grounding pad necessary.
- Works in a "wet" operative field.
◉ Risks of bipolar energy. Answer: May cut patent blood vessels before
adequate sealing. Device will not work if there is metal between the
jaws.
◉ Risk of ultrasonic dissection (harmonic). Answer: The active blade
can inadvertently injure something due to high frequency (50mHz).
◉ Does aspirin need to be discontinued day of surgery. Answer: No
, ◉ How to best enter a patient with bowel obstruction. Answer: Direct
visualization.
◉ Cut vs Coag Answer: Cut: Heats tissue quickly to convert cell water
to steam, lysing the cell.
Coag - Heat more widely dispersed, less cutting.
◉ Benefits of "Cut mode" Answer: - Low voltage
- High frequency
- Continuous waveform
- Heats tissue quickly. Cell water converts to steam and causes the cell to
lyse/explode.
◉ Benefits of "Coagulation mode" Answer: - High voltage
- Low frequency
- Intermittent waveform
- Rapid tissue heating, shallow depth of necrosis.
- Non-contact. Relies on sparking to tissue.
◉ What is direct coupling? Answer: When a monopolar instrument is in
direct contact with another metal instrument and energy is transferred.