Dr. Rowan Molnar: Pelvic laparoscopy and anaesthesia


Pelvic laparoscopy has undergone massive changes in terms of instrumentation and techniques, which has made it a popular procedure over laparotomy.  The technique is known to offer better visualisation of the pelvic viscera. The patient’s arms are placed at the side for the surgeon to have easy access after the induction of general anaesthesia.

Anaesthetic technique

According to Dr. Rowan Molnar, a Staff Specialist Anaesthetist Launceston General Hospital, Tasmania, Australia it is essential for the anaesthetic technique used in laparoscopy to compensate for physiological disturbances. Premedication is decided on by the anaesthetist and is used to reduce any anxiety felt by the patient. An intravenous cannula is introduced in the hand or forearm vein with an extension attached to the tubing for easy introduction of injections. Induction is performed with anaesthetics where the tip of a short cuffed tube is secured beyond the larynx. The anaesthetist uses agents such as nitrous oxide and oxygen anaesthesia which is supplemented with short acting narcotic analgesics to induce muscle relaxation.

In pelvic laparoscopy, ventilation is controlled by a respirometer which monitors tidal and minute volumes, and is used to adjust ventilation. Following the administration of anaesthesia, the patient’s legs are secured on stirrups and the feet dropped off the table. After the procedure, patients require to spend time in the recovery area until the effects of anaesthesia wear off. Outpatients are usually discharged the same day as the procedure depending on the type of anaesthesia given once vital signs such as blood pressure, pulse and breathing are stable.

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