Minimally Invasive Surgery — MCQs

Q: Endoscope is sterilized by:

Glutaraldehyde. **Glutaraldehyde** - **Glutaraldehyde** is a high-level disinfectant used for sterilizing heat-sensitive instruments like endoscopes, as it effectively kills bacteria, viruses, fungi, and spores without damaging the instruments. - Endoscopes cannot withstand the high temperatures of autoclaving, making chemical disinfection with agents like **glutaraldehyde** the preferred method. *Formalin* - **Formalin** (formaldehyde solution) is a strong disinfectant and sterilant, but it is highly toxic, irritating, and has a strong pungent odor, making it less suitable for routine clinical sterilization of endoscopes compared to glutaraldehyde. - While effective, its safety profile and handling difficulties mean it is not the primary choice for endoscope reprocessing in most healthcare settings. *Autoclaving* - **Autoclaving** uses high-pressure steam and high temperatures to sterilize instruments, which would damage the delicate optical fibers, electronics, and heat-sensitive plastics of endoscopes. - For this reason, endoscopes are considered **heat-labile** and cannot be sterilized using an autoclave. *Boiling* - **Boiling** is a low-level disinfection method that is insufficient to achieve sterilization as it does not kill bacterial spores and some viruses. - While it can disinfect some instruments, it is inadequate for complex medical devices like endoscopes that require high-level disinfection or sterilization.

Q: Which is the most frequently used gas for laparoscopy?

Carbon Dioxide. ***Correct: Carbon Dioxide*** - **Carbon dioxide (CO2)** is the most commonly used gas for creating **pneumoperitoneum** in laparoscopy due to its high solubility in blood and rapid elimination through the respiratory system. - Its rapid absorption minimizes the risk of **gas emboli**, and its lower cost makes it a practical choice. *Incorrect: Helium* - While helium can be used, it is generally reserved for patients who cannot tolerate **CO2 insufflation**, such as those with severe **hypercapnia** or acidosis. - Helium is less soluble in blood, increasing the risk of **gas embolism**, and is also more expensive. *Incorrect: Nitrogen* - **Nitrogen** is generally avoided in laparoscopic procedures because of its low solubility in blood, which poses a significant risk of **gas embolism**. - Its slow absorption from the peritoneal cavity can prolong recovery and is less desirable than CO2. *Incorrect: Oxygen* - **Oxygen** is not used for creating **pneumoperitoneum** because it supports combustion and would increase the risk of fire during surgical procedures involving electrocautery or lasers. - Additionally, like nitrogen, its solubility and physiological effects are not ideal for laparoscopic insufflation.

Practice by Chapter

Laparoscopic Equipment and Instrumentation

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Physiological Changes in Laparoscopy

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Laparoscopic Access Techniques

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Laparoscopic Cholecystectomy

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Laparoscopic Appendectomy

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Laparoscopic Hernia Repair

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Laparoscopic Colorectal Surgery

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Laparoscopic Upper GI Surgery

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Robotic Surgery

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Single Incision Laparoscopic Surgery

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NOTES (Natural Orifice Transluminal Endoscopic Surgery)

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Complications of Minimally Invasive Surgery

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