November 19, 2017

Before Your First: Laparoscopy

28 minutes

Your first time in the OR for a laparoscopic case can feel high-stakes. This episode covers everything from how to be helpful during setup and patient positioning, to the anatomy you'll see on screen, entry techniques, port placement, common GYN procedures, and what to watch for in post-op recovery.

Show Outline:

Before the Case – Review anatomy, know the case and why, greet the patient, help set up stirrups/yellowfins, scrub in properly

Prep – Abx if entering uterus or vagina (i.e., hyst). Chloraprep or similar (EtOH-based – must evaporate before draping!). Vaginal prep with betadine or chlorhexidine.

Uterine Manipulators – Many sizes/shapes/types. Vagina is dirty – can't go from vagina to abdomen.

Abdominal Entry – Typically in the umbilicus. Options: direct visualization with Hasson, Visiport, Veress needle. Insufflate with CO2. Palmer's Point if needed.

Port Placement – Middle ⅓ between ASIS and umbilicus. Avoid superficial vessels and inferior epigastric arteries – watch from below.

Common Procedures – Diagnostic LSC (endometriosis, adhesions), tubal ligation or bilateral salpingectomy, cystectomy, BSO, hysterectomy

Closing – Close fascia on ports >5mm (hernia risk)

Post-Op – Many cases are same-day. Check nausea/vomiting, eating/drinking, voiding, flatus, ambulation, UOP, BPs.

About the Speaker:

Jennifer Doorey, MD, MS – Academic Ob/Gyn at The Johns Hopkins University School of Medicine. As the founder of MedReady, Dr. Doorey seeks to advance clinical medical education by developing resources for medical students and clinical educators.

Procedure Ready: Ob/Gyn is a podcast aimed at medical, PA, and NP students entering their clinical rotation in Ob/Gyn. The views expressed are the speaker's own and do not constitute medical advice.

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By Jennifer Doorey, MD, MS

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