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Minimally Invasive Surgery Fundamentals

All of the following are contraindications to the use of pneumoperitoneum during laparoscopy EXCEPT:

a. Acute glaucoma

b. Peritoneal shunt

c. Second-trimester pregnancy

d. Increased intracranial pressure

Which of the following parameters is NOT increased during laparoscopy?

a. Blood pressure

b. Intraabdominal pressure

c. Glomerular filtration rate

d. Systemic vascular resistance

What is a consequence of hypercarbia?

a. Acidemia

b. Arrhythmia

c. Tachycardia

d. All of the above

Which of the following favors better oxygenation during laparoscopy?

a. Thin patient

b. Upward displacement of the diaphragm

c. Diminished functional residual capacity

d. Stiffening of the diaphragm and chest wall during insufflation

A woman with a history of coronary artery disease presents with an adnexal mass. After thorough review, she is determined to be an appropriate candidate for a laparoscopic procedure. What measures can you take to minimize the risk of cardiovascular morbidity?

a. Lay the patient on a gel pad

b. Use steeper Trendelenburg

c. Increase the intraabdominal pressure

d. Decrease the intraabdominal pressure and flatten the degree of Trendelenburg

To effectively compensate for difficulties encountered during laparoscopy in an obese patient, a surgeon may use all of the following EXCEPT:

a. Steeper Trendelenburg position to improve patient ventilation

b. Veress needle insertion at an angle that is nearly perpendicular to the skin

c. Placement of additional ancillary ports to assist in lifting a fattier omentum from the operating field

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