Patient Positioning and Operating Room Setup

We often use epidural anesthesia if colorectal resection is anticipated at the same time as diagnostic laparoscopy. The patient is usually placed in modified lithotomy position and sequential pneumatic devices on the lower extremities are routinely used. The arms are placed at the patient's sides and the patient is secured in position with either a bean bag or Plexiglas sleighs because steep rotation and tilting of the operating table is often necessary. Monitors are placed on the right and left sides of the table and the exact position is dictated by any additional procedures to be performed (Figure 10.1.1).

Operating Room And Patient Positioning
Figure 10.1.1. Positions of the surgical team and equipment for the diagnostic laparoscopy at the beginning of the procedure.

Table 10.1.1. Specific instruments recommended for diagnostic laparoscopy

3-5 Cannulae (1 X 10 mm, 2-4 X 5 mm; only 5-mm cannulae may be used if a 5-mm videoscope is available) 2 Laparoscopic bowel graspers

1 Laparoscopic ultrasound

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