Myelomeningocele short case presentation ppt
myelomeningocele
CDC myelomeningocele spina bifida facts clinical care
myelomeningocele clinical photograph lumbosacral sac diagram
https://www.cdc.gov/spina-bifida/living-with/children.html
~/
mkdir -p "/tmp/workspace/myelomeningocele-short-case/src" "/tmp/workspace/myelomeningocele-short-case/output" && python - <<'PY' from pathlib import Path p=Path('/tmp/workspace/myelomeningocele-short-case/src/create_ppt.py') p.write_text(r'''from pptx import Presentation from pptx.util import Inches, Pt from pptx.dml.color import RGBColor from pptx.enum.shapes import MSO_SHAPE from pptx.enum.text import PP_ALIGN, MSO_ANCHOR from pptx.enum.dml import MSO_THEME_COLOR from pptx.enum.text import MSO_AUTO_SIZE OUT='/tmp/workspace/myelomeningocele-short-case/output/Myelomeningocele_Short_Case_Presentation.pptx' prs=Presentation(); prs.slide_width=Inches(13.333); prs.slide_height=Inches(7.5) blank=prs.slide_layouts[6] NAVY=RGBColor(13,45,71); BLUE=RGBColor(31,111,153); TEAL=RGBColor(22,139,145); PALE=RGBColor(236,246,248); SKY=RGBColor(223,239,248); RED=RGBColor(181,54,57); INK=RGBColor(30,43,55); GREY=RGBColor(93,108,121); WHITE=RGBColor(255,255,255); LINE=RGBColor(205,220,228) def rect(s,x,y,w,h,fill,line=None,r=False): sh=s.shapes.add_shape(MSO_SHAPE.ROUNDED_RECTANGLE if r else MSO_SHAPE.RECTANGLE, Inches(x), Inches(y), Inches(w), Inches(h)); sh.fill.solid(); sh.fill.fore_color.rgb=fill; sh.line.color.rgb=line or fill if r: sh.adjustments[0]=0.08 return sh def txt(s,text,x,y,w,h,size=18,color=INK,bold=False,align=None,font='Aptos',valign=MSO_ANCHOR.TOP): box=s.shapes.add_textbox(Inches(x), Inches(y), Inches(w), Inches(h)); tf=box.text_frame; tf.clear(); tf.word_wrap=True; tf.margin_left=tf.margin_right=Pt(0); tf.margin_top=tf.margin_bottom=Pt(0); tf.vertical_anchor=valign for i,line in enumerate(text.split('\n')): p=tf.paragraphs[0] if i==0 else tf.add_paragraph(); p.text=line; p.font.name=font; p.font.size=Pt(size); p.font.bold=bold; p.font.color.rgb=color; p.space_after=Pt(4) if align: p.alignment=align return box def title(s,num,heading,sub=''): rect(s,0,0,13.333,.18,TEAL); txt(s,f'{num:02d}',.55,.42,.45,.35,13,TEAL,True); txt(s,heading,1.05,.34,11.65,.48,27,NAVY,True); if sub: txt(s,sub,1.06,.88,11.6,.26,11,GREY) rect(s,.55,1.22,12.23,.012,LINE) txt(s,'MYELOMENINGOCELE | SHORT CASE PRESENTATION',.55,7.12,7,.18,8,GREY,True) def bullet(s,items,x,y,w,h,size=17): box=s.shapes.add_textbox(Inches(x), Inches(y), Inches(w), Inches(h)); tf=box.text_frame; tf.clear(); tf.word_wrap=True; tf.margin_left=Pt(2); tf.margin_top=Pt(2) for i,item in enumerate(items): p=tf.paragraphs[0] if i==0 else tf.add_paragraph(); p.text=item; p.level=0; p.font.name='Aptos'; p.font.size=Pt(size); p.font.color.rgb=INK; p.space_after=Pt(10); p.bullet=True return box def card(s,label,body,x,y,w,h,color=PALE): rect(s,x,y,w,h,color,LINE,True); txt(s,label,x+.22,y+.16,w-.44,.25,11,TEAL,True); txt(s,body,x+.22,y+.52,w-.44,h-.65,15,INK,False) # 1 s=prs.slides.add_slide(blank); rect(s,0,0,13.333,7.5,NAVY); rect(s,0,0,13.333,.16,TEAL); txt(s,'PEDIATRIC SURGERY / NEUROSURGERY',.72,.72,5,.25,12,RGBColor(169,220,223),True); txt(s,'Myelomeningocele',.72,1.25,8,1,38,WHITE,True); txt(s,'Short case presentation',.74,2.3,6,.4,21,RGBColor(213,233,241)); # simple neural tube illustration rect(s,8.9,1.1,3.2,4.6,RGBColor(22,64,92),None,True); rect(s,9.98,1.58,1.04,2.6,TEAL,None,True); rect(s,9.55,3.7,1.9,1.25,RED,None,True); txt(s,'Open neural tube defect\nwith herniated neural tissue',9.25,5.05,2.5,.5,11,WHITE,False,PP_ALIGN.CENTER); txt(s,'Illustrative educational diagram',.74,6.78,4,.22,10,RGBColor(169,220,223)); # 2 s=prs.slides.add_slide(blank); title(s,2,'Case summary','Illustrative neonatal short case - adapt demographics and examination to your patient') card(s,'PATIENT','Term male neonate, day 1 of life\nBirth weight: 3.0 kg\nDelivered vaginally after an unbooked pregnancy',.65,1.6,3.8,1.65) card(s,'PRESENTING FINDING','Lumbosacral midline swelling present at birth, not covered by skin. No active CSF leak noted.',4.78,1.6,3.8,1.65,SKY) card(s,'MATERNAL HISTORY','No periconceptional folic acid supplementation. Antenatal anomaly scan not available.',8.91,1.6,3.8,1.65) card(s,'WORKING DIAGNOSIS','Open lumbosacral myelomeningocele with possible associated Chiari II malformation and hydrocephalus.',.65,3.65,12.06,1.15,PALE) txt(s,'Immediate priorities',.7,5.25,3,.3,18,NAVY,True) bullet(s,['Protect exposed placode with sterile saline-moistened non-adherent dressing','Prone or lateral positioning; avoid pressure and trauma to the sac','Urgent multidisciplinary assessment: neurosurgery, neonatology, urology and orthopedics'],.75,5.65,11.6,1.2,15) #3 s=prs.slides.add_slide(blank); title(s,3,'Focused examination','Document the lesion and establish neurological baseline') rect(s,.68,1.6,4.05,4.8,PALE,LINE,True); txt(s,'LOCAL EXAMINATION',.95,1.88,3.4,.28,13,TEAL,True); bullet(s,['Lumbosacral cystic mass, approximately 5 x 4 cm','Thin membrane / exposed neural placode','Assess: integrity, CSF leak, infection, bleeding','Identify level of defect and surrounding skin'],.95,2.35,3.4,3.4,16) rect(s,4.98,1.6,3.55,4.8,SKY,LINE,True); txt(s,'NEUROLOGICAL EXAMINATION',5.25,1.88,3,.28,13,BLUE,True); bullet(s,['Tone and spontaneous leg movements','Segmental motor function','Sensation and reflexes','Anal wink and sphincter function','Foot deformity, hip posture, contractures'],5.25,2.35,2.95,3.4,16) rect(s,8.78,1.6,3.85,4.8,RGBColor(255,243,241),LINE,True); txt(s,'SYSTEMIC SCREEN',9.05,1.88,3,.28,13,RED,True); bullet(s,['Head circumference, fontanelle tension and sutures','Respiratory or swallowing signs suggesting brainstem involvement','Renal and bladder assessment','Search for associated anomalies'],9.05,2.35,3.15,3.4,16) #4 s=prs.slides.add_slide(blank); title(s,4,'Assessment and investigations','The lesion level predicts functional impairment; search systematically for associated abnormalities') card(s,'CLINICAL','Serial head circumference\nCranial nerve / brainstem signs\nDetailed lower-limb motor and sensory charting',.7,1.65,3.8,1.5,PALE) card(s,'IMAGING','Cranial ultrasound: ventriculomegaly\nMRI brain and spine: lesion anatomy, Chiari II, tethering / syrinx',4.77,1.65,3.8,1.5,SKY) card(s,'UROLOGICAL','Renal-bladder ultrasound\nUrinalysis/culture if indicated\nPlan urodynamic surveillance',8.84,1.65,3.8,1.5,RGBColor(244,248,235)) txt(s,'Expected associations',.72,3.75,3,.32,19,NAVY,True) # association row for x,l,b,c in [(0.72,'Hydrocephalus','Monitor clinically and by cranial ultrasound',TEAL),(4.78,'Chiari II','Posterior fossa / brainstem involvement',BLUE),(8.84,'Neurogenic bladder','Renal protection and continence planning',RED)]: rect(s,x,4.28,3.78,1.35,c,c,True); txt(s,l,x+.2,4.5,3.35,.25,15,WHITE,True); txt(s,b,x+.2,4.86,3.35,.4,11,WHITE) txt(s,'Differential: meningocele has no neural tissue in the sac; myelomeningocele contains neural tissue and carries greater neurological morbidity.',.75,6.15,11.8,.45,13,GREY,False) #5 s=prs.slides.add_slide(blank); title(s,5,'Management plan','Treat as a neonatal surgical and lifelong multidisciplinary condition') # timeline steps=[('0-24 HOURS','Protect lesion\nSterile moist dressing\nProne/lateral position\nThermal support and antibiotics per local protocol',TEAL),('EARLY SURGERY','Neurosurgical closure\nDural repair and soft-tissue cover\nTiming is individualized by centre and infant status',BLUE),('ONGOING CARE','Manage hydrocephalus if present\nBladder/bowel programme\nPhysio, orthoses, skin and orthopedic surveillance',RED)] for i,(h,b,c) in enumerate(steps): x=.7+i*4.08; rect(s,x,1.85,3.58,3.6,RGBColor(247,250,251),LINE,True); rect(s,x,1.85,3.58,.65,c,c,True); txt(s,h,x+.2,2.04,3.1,.25,14,WHITE,True); txt(s,b,x+.25,2.8,3.05,2.25,16,INK) if i<2: txt(s,'→',x+3.65,3.3,.35,.4,25,GREY,True,PP_ALIGN.CENTER) txt(s,'Key message: closure protects neural tissue and reduces infection risk, but does not reverse established neurological deficits.',.75,6.05,11.7,.45,15,NAVY,True) #6 s=prs.slides.add_slide(blank); title(s,6,'Counselling, prevention and prognosis','Functional outcome depends mainly on neurological level and associated complications') card(s,'FAMILY COUNSELLING','Explain the lesion, anticipated motor/sensory deficit, bowel and bladder dysfunction, hydrocephalus surveillance, and need for long-term coordinated care.',.7,1.6,5.85,1.65,PALE) card(s,'PREVENTION','Periconceptional folic acid lowers neural tube defect risk. Offer preconception counselling and review future-pregnancy folate dose according to local guideline and risk profile.',6.8,1.6,5.85,1.65,SKY) txt(s,'Follow-up domains',.72,3.75,3,.32,19,NAVY,True) bullet(s,['Neurosurgery: hydrocephalus, Chiari II, tethered cord','Urology: renal preservation, catheterisation and continence','Orthopedics / rehabilitation: mobility, deformity, pressure care','Developmental and psychosocial support; transition to adult services'],.78,4.25,11.1,1.75,16) rect(s,.7,6.24,11.9,.52,NAVY,NAVY,True); txt(s,'Exam takeaway: an open lumbosacral sac containing neural tissue is myelomeningocele until proven otherwise.',.95,6.4,11.35,.2,13,WHITE,True,PP_ALIGN.CENTER) #7 s=prs.slides.add_slide(blank); title(s,7,'References and discussion prompts','Sources used for teaching content') txt(s,'Core references',.7,1.55,3,.3,19,NAVY,True) bullet(s,['Bailey & Love’s Short Practice of Surgery, 28th ed. “Spina bifida”, pp. 1552-1574.','Bradley and Daroff’s Neurology in Clinical Practice. “Myelomeningocele and Encephalocele”, pp. 3013-3045.','CDC. Infants, Toddlers, and Children: Spina Bifida. Updated web guidance, accessed 7 Oct 2026.','Semione GG et al. Prenatal versus postnatal surgical management for myelomeningocele: systematic review and comparative meta-analysis. Neurosurgery. 2026. PMID: 41636521.'],.75,2.02,11.75,2.75,14) rect(s,.7,5.15,11.9,1.2,PALE,LINE,True); txt(s,'Questions for viva',.98,5.38,2.4,.25,14,TEAL,True); txt(s,'1. Differentiate myelomeningocele from meningocele. 2. List immediate neonatal priorities. 3. What complications require lifelong surveillance?',.98,5.76,11,.3,14,INK) txt(s,'Content is for education and must be adapted to local neonatal surgical protocols.',.75,6.77,8,.2,10,GREY) # common metadata prs.core_properties.title='Myelomeningocele - Short Case Presentation'; prs.core_properties.subject='Illustrative neonatal short case'; prs.core_properties.author='Orris'; prs.save(OUT) print(OUT) ''') PY python "/tmp/workspace/myelomeningocele-short-case/src/create_ppt.py" && ls -lh "/tmp/workspace/myelomeningocele-short-case/output/Myelomeningocele_Short_Case_Presentation.pptx"
python - <<'PY' from pptx import Presentation p='/tmp/workspace/myelomeningocele-short-case/output/Myelomeningocele_Short_Case_Presentation.pptx' prs=Presentation(p) print('slides', len(prs.slides)) for i,sl in enumerate(prs.slides,1): texts=[] for sh in sl.shapes: if sh.has_text_frame: t=sh.text_frame.text.strip().replace('\n',' | ') if t: texts.append(t) print(i, ' | '.join(texts)[:240]) PY python - <<'PY' from zipfile import ZipFile p='/tmp/workspace/myelomeningocele-short-case/output/Myelomeningocele_Short_Case_Presentation.pptx' with ZipFile(p) as z: bad=z.testzip() print('zip_integrity', bad or 'OK') PY
Myelomeningocele Short Case Presentation
Presentation · PPTX
Various surgical instruments including laproscopy along with uses as viva points
- Basic open-surgery instruments: scalpel, artery forceps, tissue forceps, scissors, needle holders, retractors, suction.
- Specialty instruments: bowel, vascular, thyroid, orthopedic, obstetric and gynecologic instruments.
- Laparoscopic instruments: telescope, camera, light source, insufflator, Veress needle, trocars, graspers, dissectors, clip applier, electrosurgical devices, specimen retrieval bag.
- Viva points for each: identification, main use, key feature, common sizes, precautions, and one common follow-up question.
- PPTX deck: illustrated slides with viva points
- Short viva notes: concise table for rapid revision
- Detailed instrument catalogue: comprehensive specialty-wise notes
Short viva notes
laparoscopic surgery instruments
SAGES laparoscopic equipment trocar insufflator telescope surgical education
Surgical Instruments: Short Viva Notes
How to answer in viva
A. Basic General Surgical Instruments
| Instrument | Identification / key feature | Main uses | Viva point / precaution |
|---|---|---|---|
| Bard-Parker scalpel handle | Handle with detachable blade | Making skin and soft-tissue incisions | No. 3 handle commonly takes smaller blades, No. 4 larger blades. Pass with blade pointing away. |
| No. 10 blade | Curved cutting edge | Large skin incisions | Commonly used for laparotomy incision. |
| No. 11 blade | Triangular pointed blade | Stab incision, drain site, arteriotomy | Do not use for long skin incisions. |
| No. 15 blade | Small curved blade | Precise short incisions | Useful in pediatric, plastic, and vascular work. |
| Mayo scissors | Heavy, broad blades | Cutting fascia, sutures, tough tissue | Straight Mayo: sutures. Curved Mayo: deeper tissue/fascia. |
| Metzenbaum scissors | Delicate, long shanks, narrow blades | Fine soft-tissue dissection | Not for cutting sutures or tough fascia. |
| Lister bandage scissors | Blunt foot on lower blade | Cutting dressings and bandages | Blunt tip protects skin. |
| Artery forceps / hemostat | Ring handles, ratchet lock, serrated jaws | Clamping bleeding vessels before ligation | Mosquito is small and delicate; Kelly/Spencer-Wells are larger. Avoid crushing delicate structures. |
| Kocher forceps | Transverse serrations with terminal tooth | Holding tough tissue, fascia, pedicles | Tooth gives secure grip but can traumatize bowel or delicate tissue. |
| Allis tissue forceps | Multiple interlocking teeth | Holding fascia, skin edge, tissue for excision | Traumatic. Avoid on bowel, ureter, or viable delicate tissue. |
| Babcock forceps | Fenestrated, atraumatic rounded jaws | Holding bowel, appendix, fallopian tube, ureter | Preferred over Allis for hollow viscera. |
| Sponge-holding forceps | Ring-shaped jaws | Holding swabs for painting, mopping, blunt dissection | Never leave a sponge in the cavity. |
| Plain dissecting forceps | No teeth | Handling delicate tissue, dressings | Less traumatic but less firm grip. |
| Toothed forceps | 1 x 2 teeth at tip | Holding skin, fascia, tough tissue | Use toothed forceps for skin to avoid crushing it. |
| Adson forceps | Small thumb forceps, may be toothed | Skin and fine tissue handling | Common in minor surgery. |
| Mayo-Hegar needle holder | Short, stout jaws with ratchet | Holding needle during suturing | Hold needle at junction of middle and proximal third, not at tip or swage. |
| Towel clip / Backhaus clip | Sharp pointed tips with ratchet | Securing drapes; may hold tubing | Do not apply directly to skin unless specifically intended. |
| Lane tissue forceps | Strong toothed jaws | Grasping tough tissue, especially fascia | Traumatic instrument. |
| Doyen intestinal clamp | Long, atraumatic bowel clamp | Temporary occlusion of bowel | Non-crushing clamp. Do not confuse with crushing intestinal clamp. |
| Payr intestinal clamp | Crushing bowel clamp | Crushing bowel before resection | Applied only to bowel segment intended for resection. |
B. Retractors and Suction
| Instrument | Main use | Viva point |
|---|---|---|
| Langenbeck retractor | Superficial wound retraction | Hand-held, right-angled blade. |
| Army-Navy retractor | Retracting skin and superficial tissue | Double-ended hand-held retractor. |
| Deaver retractor | Deep abdominal or pelvic retraction | Broad curved blade, useful for viscera. |
| Morris retractor | Deep abdominal wall retraction | Broad right-angled blade. |
| Richardson retractor | Deep wound retraction | Often used in open abdominal surgery. |
| Balfour retractor | Self-retaining abdominal retractor | Used in laparotomy; has central and lateral blades. |
| Weitlaner retractor | Self-retaining retractor for shallow wounds | Sharp or blunt prongs. Protect skin edges. |
| Gelpi retractor | Self-retaining retractor for deeper narrow wounds | Single sharp hooks at ends. |
| Frazier suction cannula | Fine suction, especially neurosurgery/ENT | Has thumb vent to control suction. |
| Yankauer suction | Suction of blood and secretions | Commonly used in general surgery and anesthesia. |
| Poole suction | Suction of large volumes in abdomen | Multiple side holes reduce tissue trauma and blockage. |
C. Common Specialty Instruments
| Instrument | Main use | Viva point |
|---|---|---|
| Foerster sponge forceps | Holding swab for painting and mopping | Ring jaws distinguish it from artery forceps. |
| Green-Armytage forceps | Holding uterine incision edges during cesarean section | Obstetric instrument. |
| Lane bone-holding forceps | Holding bone fragments | Orthopedic instrument; strong grip. |
| Bone cutter / Liston cutter | Cutting bone | Used in orthopedic procedures. |
| Gigli saw | Cutting bone, especially skull or long bone | Flexible wire saw. |
| Volkmann curette | Scraping granulation tissue or bone cavity | “Spoon curette.” |
| Malleable retractor | Deep retraction and protection of viscera | Can be bent to desired shape. |
| Satinsky vascular clamp | Partial occlusion of large blood vessels | Allows vascular control while preserving flow through remaining lumen. |
| Bulldog clamp | Temporary occlusion of small vessels | Small spring-loaded atraumatic vascular clamp. |
| Right-angle clamp / Mixter | Passing ligature around deep vessels or ducts | Commonly used around cystic duct or vessels. |
| Desjardins forceps | Retrieval of common bile duct stones | Long forceps with characteristic angled tip. |
| Stone-holding forceps | Holding bladder stones during cystolithotomy | Urology instrument. |
D. Laparoscopic Instruments and Viva Points
| Instrument | Identification / function | Main uses | Important viva point |
|---|---|---|---|
| Laparoscope / telescope | Rigid rod-lens scope, commonly 5 mm or 10 mm; 0° or 30° view | Visualisation of abdominal/pelvic cavity | A 30° telescope allows viewing around structures by rotating the scope. |
| Camera head and camera control unit | Attached to telescope | Converts optical image into monitor image | White balance and focus should be checked before starting. |
| Light source and fiber-optic cable | Delivers illumination to telescope | Lighting operative field | Cable tip becomes hot. Avoid contact with drapes or skin. |
| CO₂ insufflator | Delivers carbon dioxide at controlled pressure and flow | Creates and maintains pneumoperitoneum | CO₂ is preferred because it is nonflammable and highly soluble in blood. |
| Veress needle | Spring-loaded blunt stylet within sharp outer needle | Closed technique for creating pneumoperitoneum | Confirm correct intraperitoneal placement before insufflation. Incorrect placement can cause visceral or vascular injury. |
| Hasson cannula | Blunt port with cone and fixation sutures | Open laparoscopic entry | Useful where adhesions are suspected or in some high-risk entries. |
| Trocar and cannula / port | Cannula provides access; trocar obturator facilitates insertion | Passage for telescope and instruments | Common diameters are 5 mm, 10 mm and 12 mm. Larger ports may need fascial closure. |
| Optical trocar | Port allowing visualised entry | Abdominal access under direct vision | Reduces blind entry but does not eliminate injury risk. |
| Maryland dissector | Curved fine jaws | Fine dissection, especially Calot’s triangle | Common instrument in laparoscopic cholecystectomy. |
| Laparoscopic grasper | Long shaft with atraumatic or toothed jaws | Holding and retracting tissue | Use atraumatic grasper for bowel, tube, and delicate structures. |
| Babcock laparoscopic grasper | Fenestrated atraumatic jaws | Holding bowel, appendix, fallopian tube | Avoid excessive traction on hollow viscera. |
| Laparoscopic scissors | Long shaft with cutting blades | Cutting tissue, sutures, adhesions | May be monopolar compatible. Beware thermal injury if energized. |
| Hook electrode | Hook-shaped monopolar electrode | Dissection and coagulation | Commonly used in cholecystectomy. Maintain visual control of active tip. |
| Spatula electrode | Flat spatula-shaped electrode | Superficial coagulation and dissection | Avoid stray energy injury. |
| Bipolar forceps | Two opposing active electrodes | Coagulation of vessels/tissue | Energy passes between jaws, limiting spread compared with monopolar energy. |
| Suction-irrigation cannula | Long hollow cannula with suction and irrigation channels | Clearing blood/smoke; lavage; blunt dissection | Keep tip visible to prevent injury and avoid suctioning bowel/omentum. |
| Clip applicator | Applies metal or polymer clips | Ligating cystic duct and cystic artery | Ensure correct structure is fully within jaws before firing. |
| Endoscopic stapler | Applies rows of staples and divides tissue | Bowel division, vascular pedicles, lung surgery | Check cartridge size, tissue thickness and complete staple-line formation. |
| Endobag / specimen retrieval bag | Collapsible bag introduced through port | Retrieval of gallbladder, appendix, ovarian cyst, specimen | Reduces port-site contamination and specimen spillage. |
| Needle driver | Laparoscopic needle holder | Intracorporeal suturing | Needle must be securely grasped and continuously visualised. |
| Fan retractor | Expandable fan-shaped retractor | Retraction of liver or viscera | Insert closed, open only under vision, avoid excessive pressure. |
Essential Laparoscopy Viva Questions
1. Why is CO₂ used for pneumoperitoneum?
- Nonflammable, so compatible with electrosurgery.
- Highly soluble in blood and rapidly excreted by lungs.
- Cheap and readily available.
2. What are common telescope sizes and angles?
- 5 mm and 10 mm are common diameters.
- 0° telescope: straight forward view.
- 30° telescope: angled view, useful for looking above, below, or around structures.
3. What are the methods of abdominal entry?
- Closed entry with Veress needle.
- Open entry with Hasson technique.
- Optical trocar entry.
- Direct trocar entry in selected cases.
4. What are common complications of laparoscopic entry?
- Bowel injury.
- Major vascular injury.
- Bladder injury.
- Subcutaneous emphysema.
- Preperitoneal insufflation.
- Port-site bleeding.
5. What are the principles of safe laparoscopic energy use?
- Keep the active electrode tip in view.
- Use the lowest effective energy setting.
- Avoid activating near bowel, ureter, or major vessels.
- Beware insulation failure, direct coupling, capacitive coupling, and thermal spread.
6. What are common port sizes?
- 5 mm: working instruments.
- 10 mm: telescope or larger instrument.
- 12 mm: stapler or clip device, depending on system.
7. Why may a port site require fascial closure?
- To reduce risk of port-site hernia, especially after larger ports. The exact threshold and closure practice vary by patient factors, port design, and local protocol.
Quick Differentiation Questions
| Question | Answer |
|---|---|
| Allis vs Babcock? | Allis is traumatic and grips tough tissue. Babcock is atraumatic and used for bowel/tube. |
| Kocher vs artery forceps? | Kocher has a terminal tooth and grasps tough tissue. Artery forceps have serrations and clamp vessels. |
| Mayo vs Metzenbaum scissors? | Mayo cuts tough tissue/fascia. Metzenbaum is for delicate soft-tissue dissection. |
| Veress needle vs trocar? | Veress needle creates pneumoperitoneum. Trocar creates a port for scope/instruments. |
| Monopolar vs bipolar diathermy? | Monopolar current travels from active electrode through patient to return pad. Bipolar current passes between two jaws of the instrument. |
| 0° vs 30° telescope? | 0° gives straight view. 30° provides angled view and better visualization around structures. |