One commonly used instrument in laparoscopic surgery is the Laparoscopic Suction and Irrigation Tube, also known as the Suction and Irrigation Set. Unlike conventional ultrasonic scalpels, dissecting forceps, and other instruments, the Suction and Irrigation Tube has no special functions and shapes but has the basic forms of various instruments.
If used well, it can play a variety of instrument functions such as dissection, attraction, exposure, and traction. Especially in laparoscopic surgery, instrument replacement is not as convenient as open surgery, and the number of instruments that can be used during surgery is limited. A perfectly used Suction and Irrigation Tube, especially a perfectly used Suction and Irrigation Tube in the left hand, can replace the role of most instruments and greatly improve the efficiency of surgery.
Blunt dissection is significant in surgery, and the instruments needed in laparoscopy are the Suction and Irrigation tubes. The core goal of blunt dissection is to expose important tissues. The advantage is that the probability of damaging important pipes will be reduced, and the disadvantage is that a small amount of wound bleeding may occur.
There are many uses for Suction and Irrigation Tubes in laparoscopic surgery:
The main function of Suction and Irrigation Tube is to suck away the fluid in the abdominal cavity and pelvic and abdominal cavity. The following are the tips:
When the amount of fluid is large, the front opening of the Suction and Irrigation Tube should not be immersed too deeply. The better way is to just touch the liquid surface. During the suction process, the Suction and Irrigation Tube is slowly pushed forward as the liquid level decreases. In this way, the tissue around the suction head can be seen, and the fallopian tube umbrella end or omentum tissue can be avoided from being sucked in, thereby improving the suction efficiency.
When there is a blood clot that needs to be sucked out, Suction and Irrigation tubes and dissecting forceps can be used together to crush the blood clot and then suck it out.
When the wound surface is extensive and continuous bleeding needs to be exposed, the suction head end quickly passes over the wound surface and sucks at the same time, which is “sweeping suction”, which can quickly expose the bleeding point and facilitate hemostasis.
When using, continuous suction should be avoided to reduce abdominal pressure. At this time, the operation of fast suction and fast return can be adopted. Generally, suction for 1 second and stop for 2 seconds. While sucking, inflate for a certain time to avoid the impact of abdominal pressure drop on the operation.
The Suction and Irrigation Tubes are used in different ways for different purposes of flushing.
When a large amount of flushing is required intraoperatively, it is sufficient to turn on the suction directly. The heat generated by laparoscopic electrical instruments may spread to the ureter, bladder, or bowel, resulting in delayed organ damage. Suction flushing the tissue during the procedure is an excellent way to cool the tissue and may reduce the side injuries of the procedure.
When exposing smaller bleeding points, it is necessary to control how far the valve is pushed forward to create a small stream or even a drip. This allows for more accurate exposure of bleeding points and efficient hemostasis.
On the surface of the pipeline, along the long axis of the pipeline, scraping across the surface of the pipeline, the pipeline in front of the tissue gently scraped, and sucked away, revealing the target pipeline and its walk.
In the process of scraping, the use of power needs to be appropriate, which can be achieved with the pipe surface contact without pressure on the pipe, too much force is easy to damages the pipe, and too light can not be very good for revealing the target.
Blocking of blood vessels, e.g., when exposing the iliac vessels during lymph node dissection, blocking of the veins with the suction device can be used as an alternative to separating forceps.
Blocking of organs, for example, when removing the uterus and suturing the vaginal stump, blocking the bladder with the suction device assists the primary surgeon in better suturing the vaginal stump.
Downward pressure blocks the bowel and assists in exposure. Pressing the ureter laterally to keep it away from hot electrical instruments and flushing the ureter if necessary to reduce the risk of ureteral injury.
Through the tip of the Suction and Irrigation Tube, using the appropriate force, the top between the tube and the surrounding tissue, can be through the top of this action, and the gap between the tube and the surrounding tissue will be revealed. Of course, the key is to find the right position, otherwise, the gap will not appear even if the head is pushed up.
In addition, when bleeding occurs during surgery, the tip of the Suction and Irrigation Tube can be placed near the bleeding point to reduce the amount of bleeding and suction with appropriate force to keep the wound clean and create conditions for the next step of treatment. When controlling bleeding, it is necessary to use the head mainly and minimize the use of suction, especially not against the bleeding point. Otherwise, although looking at the wound clean, the bleeding instead of more.
When stripping a tumor, the use of a Suction and Irrigation Tube can assist in separating the tumor cavity while suctioning away the oozing blood.
The Suction and Irrigation Tube has a small role in the process of separating adhesions. For example, in the process of dissecting the adhesions between the ovary and the surrounding tissues in endometriosis, the blunt tip of the front end of the Suction and Irrigation Tube can separate the gap while suctioning away the blood seepage and ooze, together with the flushing water, it can effectively expose the adhesion gap, find the right direction to move forward, and quickly separate the adhesions.
After the gap between the duct and the surrounding tissue appears, the target tissue can be separated from the surrounding tissue by pushing and picking this action in the direction of the long axis of the duct to widen the gap. Of course, if a branch is found to be present, the direction of the suction movement needs to be changed to follow the branch direction to avoid injury.
Of course, surgery is seldom performed as a single action, but rather as a combination of multiple actions to maximize its effect. After the basic operation is mastered, it is the surgeon’s instinctive response to maximize the effect. Proficiency in the use of Suction and Irrigation tubes can be very helpful in the more difficult laparoscopic surgery, especially in the case of anatomical ambiguity or traumatic blood seepage, to reveal the important target ducts to be revealed.
