Page 13 - Prospectus of MS in Minimal Access Surgery

(MODULES 5 : INSTRUMENT DESIGN)
Considerations in technological development and instrument function and design

The design process
Content and manufacture
Initial research and identification of functional requirements Prototype modelling, refinement

Relationships with industry
Instrument manufacture
OBJECTIVE :

Knowledge of the function of the technology group Knowledge of confidentiality agreements Knowledge and
criticism of current projects

(MODULE 6: TISSUES)

Access Techniques
Pneumoperitoneum (Insufflation techniques, Insufflation gases, Insufflation volume and rate,
Intra-abdominal pressure). Patient positioning. Potential complications - cardiac performaance
during MAS, haemodynamic alterations with pnumoperitoneum, effects, other systemic
Content pneumoperitoneum. Anaesthetic management during endoscopy (laparoscopy and
complications. Inflammatory and metabolic response to MAS vs. Open surgery. Alternatives to

thoracoscopy) including position, monitoring, anaesthetic techniques, pain control.
Ligation and Approximation
Sutures and suture materials - history, basic principles, knots, suture characteristics, effects of
ligation, the physics of ligation. Endoscopic ligation. Nonabsorbable clips. Absorbable clips.
Ligation devices (Stapling and stapling devices: historical development, principles, equipment,
advantages and disadvantages). Endoscopic suturing: various techniques.

OBJECTIVE :

On completion of this module the student should be able to:
• Insert a Veress needle with appropriate technique and set up and operate an insufflator
• Perform various techniques for creating a pneumoperitoneum and discuss their advantages and
disadvantages
• Describe the haemodynamic and other changes associated with a pneumoperitoneum and the effects
of pressure, flow rate, volume, and the nature of gas used
• Discuss the alternatives to pneumoperitoneum and the design of associated systems.
• Effect of pneumoperitoneum or thoracoscopy on anaesthetic management
• Describe the nature, advantages and disadvantages of various clipping and stapling devices and
demonstrate their safe use
• Apply extracoporeal knots endoscopically, suture and perform a microsurgical knot intracorporeally