1. Proper posture

In laparoscopic surgery, especially gastrointestinal surgery, in principle, the surgical site (target organ) should generally be "placed" in the abdominal cavity as "high" as possible. For example, when performing right hemicolectomy, the patient’s position is often "head high and left side low", while during rectal surgery, the surgeon often takes the "head low and right side low" position. Especially when performing ultra-low rectal surgery, the patient's position may also be the extreme low-head position and low-right position.

The principle of this position is to maximize the use of gravity for exposure. The surrounding structures that hinder exposure can be effectively removed from the surgical field under the action of gravity, and the blood and tissue fluid will not affect the surgical field due to the flow of blood and tissue fluid to a low position. 

For this purpose, the patient should be properly placed on the operating table, so that the maximum use of gravity to expose the surgical field when turning the bed during the operation.

When doing abdominal surgery, we often encounter two "troublesome" guys, one is the omentum and the other is the small intestine.

We learn to use gravity, and tilting the patient's position laterally is an effective measure to remove the omentum and small intestine from the surgical field.

When performing standard laparoscopic surgery, there are a total of three "assistants" helping the surgeon, one is an assistant, the other is a hand mirror, and the most easily overlooked is the earth’s gravity.

2. Application of laparoscopic yarn

When doing laparoscopic surgery, we often use laparoscopic yarn. The laparoscopic yarn can be used to stop bleeding, protect important organs in the abdominal cavity, mark the level of the operation, and even help expose the surgical field.

In surgery, we often use a "barium yarn" mixed with X-ray opaque. After soaking this type of gauze in salt water, The 10 mm or 12 mm trocar is sent into the abdominal cavity. At this time, we rely on the physical friction between the gauze and the surface of the abdominal organs. 

In sigmoid colon or rectal surgery, when the gauze is spread and placed in the area between the inferior mesenteric artery and the level of the duodenum, the root of the inferior mesenteric artery can be easily exposed; When the gauze is placed near the ileum at the end of the right lower abdomen, it can easily expose the "yellow and white boundary" on the right side of the sigmoid mesangium. Examples like this are too numerous to list.