Te Linde’s, Chapter 16: Diagnostic and Operative Laparoscopy & Chapter 17: Robotic Surgery

Answer Key

1. What is the arcuate line and where is it located?

1/3 to ½ between the umbilicus and the pubic symphysis

2. Your patient is undergoing a laparoscopic hysterectomy. Which abdominal wall layers (in

     order) will be encountered during trocar placement below the arcuate line?

Skin, subcutaneous tissue, Camper's fascia, Scarpa's fascia, anterior rectus sheath, rectus muscle, transversalis fascia, parietal peritoneum

3. Where is Palmer’s Point?

LUQ, mid-clavicular line, 2-3cm below the costal margin

4. At what angle should an umbilical veres needle or trocar be placed in a non-obese

    patient tavoid injury to the underlying vascular structures?

45 Degrees

5. What is the major vascular structure most likely to be injured at the time of laparoscopic umbilical trocar placement?

Left common iliac vein

6. What is the last branch of the aorta?

Middle sacral artery

7. What is the origin of the inferior epigastric artery?

External iliac artery

8. If you perforate the inferior epigastric artery during trocar placement, how do you get the

     bleeding to stop?

Use a Foley balloon

9. What is the maximum intra-abdominal insufflation pressure that should be used during

     laparoscopic surgery?

20-25 mmHg

10. Name a contraindication to ICG use.

Allergy to Iodine