Video of Laparoscopic Port Position Technique: Strategic Access for Optimal Ergonomics and Surgical Precision
In this video, we will discuss that In the field of Minimal Access Surgery (MAS), the success of any laparoscopic procedure begins with one fundamental step: proper port positioning. The video titled "Laparoscopic Port Position Technique: Strategic Access for Optimal Ergonomics and Surgical Precision" provides a comprehensive guide to understanding how strategic port placement enhances visualization, instrumentation, and surgeon comfort—ultimately leading to safer and more efficient surgeries.
Importance of Correct Port Placement
The position of each laparoscopic port plays a vital role in:
Maintaining instrument triangulation
Preserving an optimal working angle and camera view
Preventing instrument clashing
Ensuring ergonomic alignment for the operating surgeon
Improper placement can lead to restricted movement, fatigue, and increased risk of errors during dissection, suturing, or tissue retrieval.
Key Principles Explained in the Video
Camera Port (Optical Port) Selection
The primary port for the laparoscope is usually placed at the umbilicus or supraumbilical level, depending on patient habitus and pathology. This provides a central view of the operative field.
Working Ports Placement
Typically 5 mm ports are placed on the left and right sides to achieve ideal triangulation around the target organ. For example:
In Total Laparoscopic Hysterectomy (TLH): three ipsilateral ports with a supraumbilical camera are preferred.
In Laparoscopic Cholecystectomy: ports are placed at the umbilicus, epigastrium, and right subcostal margin.
In Inguinal Hernia Repair (TAPP/TEP): ports are positioned to maintain symmetry and access the preperitoneal space effectively.
Assistant Port (Optional)
A fourth port may be introduced for suction, retraction, or clip application, especially in advanced or complex procedures.
Ergonomic Considerations
Ports should be placed in such a way that the surgeon’s arms, shoulders, and wrist remain in a neutral position to prevent musculoskeletal strain during long procedures.
Patient Positioning and Abdominal Insufflation
The technique of creating pneumoperitoneum with a Veress needle or open (Hasson) method is demonstrated, followed by port introduction under direct vision to avoid injury.
Instrument Reach and Angle of Approach
The video illustrates how the angle between instruments (ideally 60–90 degrees) allows smooth manipulation, suturing, and dissection.
Applications in Different Surgeries Covered in the Video
Cholecystectomy
Appendectomy
Hernia Repair (TAPP/TEP)
Total Laparoscopic Hysterectomy (TLH)
Laparoscopic Myomectomy
Colorectal and Urological Procedures
Each case requires port customization based on the target anatomy, pathology size, and instrument type (straight vs. articulating, robotic, etc.).
Conclusion
Mastering the Laparoscopic Port Position Technique is essential for any surgeon aiming to excel in minimal access surgery. Strategic port placement improves ergonomics, enhances instrument performance, and ensures procedural safety. This video is a must-watch for surgical trainees, gynecologists, and general surgeons looking to refine their approach and elevate their surgical outcomes.
Watch the full video to understand port planning in various procedures and learn how to optimize access for superior laparoscopic performance. Don’t forget to like, comment, and subscribe for more surgical education from World Laparoscopy Hospital.
Importance of Correct Port Placement
The position of each laparoscopic port plays a vital role in:
Maintaining instrument triangulation
Preserving an optimal working angle and camera view
Preventing instrument clashing
Ensuring ergonomic alignment for the operating surgeon
Improper placement can lead to restricted movement, fatigue, and increased risk of errors during dissection, suturing, or tissue retrieval.
Key Principles Explained in the Video
Camera Port (Optical Port) Selection
The primary port for the laparoscope is usually placed at the umbilicus or supraumbilical level, depending on patient habitus and pathology. This provides a central view of the operative field.
Working Ports Placement
Typically 5 mm ports are placed on the left and right sides to achieve ideal triangulation around the target organ. For example:
In Total Laparoscopic Hysterectomy (TLH): three ipsilateral ports with a supraumbilical camera are preferred.
In Laparoscopic Cholecystectomy: ports are placed at the umbilicus, epigastrium, and right subcostal margin.
In Inguinal Hernia Repair (TAPP/TEP): ports are positioned to maintain symmetry and access the preperitoneal space effectively.
Assistant Port (Optional)
A fourth port may be introduced for suction, retraction, or clip application, especially in advanced or complex procedures.
Ergonomic Considerations
Ports should be placed in such a way that the surgeon’s arms, shoulders, and wrist remain in a neutral position to prevent musculoskeletal strain during long procedures.
Patient Positioning and Abdominal Insufflation
The technique of creating pneumoperitoneum with a Veress needle or open (Hasson) method is demonstrated, followed by port introduction under direct vision to avoid injury.
Instrument Reach and Angle of Approach
The video illustrates how the angle between instruments (ideally 60–90 degrees) allows smooth manipulation, suturing, and dissection.
Applications in Different Surgeries Covered in the Video
Cholecystectomy
Appendectomy
Hernia Repair (TAPP/TEP)
Total Laparoscopic Hysterectomy (TLH)
Laparoscopic Myomectomy
Colorectal and Urological Procedures
Each case requires port customization based on the target anatomy, pathology size, and instrument type (straight vs. articulating, robotic, etc.).
Conclusion
Mastering the Laparoscopic Port Position Technique is essential for any surgeon aiming to excel in minimal access surgery. Strategic port placement improves ergonomics, enhances instrument performance, and ensures procedural safety. This video is a must-watch for surgical trainees, gynecologists, and general surgeons looking to refine their approach and elevate their surgical outcomes.
Watch the full video to understand port planning in various procedures and learn how to optimize access for superior laparoscopic performance. Don’t forget to like, comment, and subscribe for more surgical education from World Laparoscopy Hospital.
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