Minimally Invasive Surgery — MCQs

Minimally Invasive Surgery US Medical PG Practice Questions and MCQs

Question 11: What is incorrect about the instrument shown below?

A. Veress needle
B. Subumbilical insertion
C. CO2 insufflation
D. Safe in morbid obesity (Correct Answer)
E. Spring-loaded safety mechanism

Explanation: ***Safe in morbid obesity*** - The Veress needle technique has a **higher risk of complications** like bowel or vascular injury in morbidly obese patients due to the increased depth of the abdominal wall and greater technical difficulty. - While it can be used, specific modifications or alternative techniques (e.g., **open Hasson technique**) are often preferred for safety in morbid obesity. - This statement is **INCORRECT** - Veress needle is NOT considered safe in morbid obesity. *Veress needle* - The image shown is indeed a Veress needle, identifiable by its blunt, spring-loaded inner stylet. - It is primarily used for insufflation to create pneumoperitoneum in laparoscopic surgery. *Subumbilical insertion* - The subumbilical region is a common and preferred site for Veress needle insertion. - The abdominal wall is generally thinner at this location, making it a relatively safe access point. *CO2 insufflation* - The Veress needle is specifically designed to facilitate CO2 insufflation into the peritoneal cavity. - This creates pneumoperitoneum, lifting the abdominal wall away from internal organs. *Spring-loaded safety mechanism* - The Veress needle features a spring-loaded blunt inner stylet that retracts during insertion and springs forward once in the peritoneal cavity. - This mechanism helps prevent tissue damage to underlying organs.

Question 12: Identify the instrument shown below.

A. Laparoscopic port trocar (Correct Answer)
B. Peritoneal dialysis catheter
C. Endoscopic ultrasound probe
D. DPL catheter
E. Veress needle

Explanation: ***Laparoscopic port trocar*** - The image clearly displays **multiple incisions** on an abdomen with tubular instruments inserted, which are characteristic of a laparoscopic procedure. - The instruments visible with their external components and internal shafts are consistent with **trocars**, used to create and maintain access ports for laparoscopic tools. *Peritoneal dialysis catheter* - A peritoneal dialysis catheter typically involves a **single, soft silicone tube** permanently implanted in the abdomen for fluid exchange, which is not what is shown. - The pictured instruments are rigid and designed for temporary insertion during surgery, not for long-term dialysis. *Endoscopic ultrasound probe* - An endoscopic ultrasound probe is a **flexible instrument** with a camera and ultrasound transducer at its tip, inserted through natural orifices (e.g., mouth, anus). - The instruments in the image are rigid, percutaneous, and used for access into the abdominal cavity, not for internal ultrasound imaging via endoscopy. *DPL catheter* - A DPL (Diagnostic Peritoneal Lavage) catheter is a **single, small catheter** inserted into the peritoneal cavity for diagnostic fluid aspiration, often in trauma. - The presence of multiple, significantly larger instruments with complex external mechanisms strongly indicates a surgical procedure rather than a simple diagnostic lavage. *Veress needle* - A Veress needle is a **thin, spring-loaded needle** used to create initial pneumoperitoneum before trocar insertion in laparoscopy. - Unlike the **larger, hollow trocars** shown in the image, the Veress needle is much smaller (typically 2mm diameter) and is removed before the trocars are placed.

Practice by Chapter

CO2 insufflation physiology

Practice Questions

Complications of minimally invasive surgery

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Conversion to open surgery criteria

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Cost-effectiveness of minimally invasive surgery

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Endoscopic procedures overview

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Laparoscopic instrumentation

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Laparoscopic surgery principles

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Learning curve considerations

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Natural orifice transluminal surgery

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Patient selection for minimally invasive approaches

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Robotic surgery principles

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Single-incision laparoscopic surgery

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Trocar placement and port sites

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