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Gynaecology & Obstetrics Gynaecological Diagnosis e1b2a49a

Laparoscopy is contraindicated in:

A
Ectopic pregnancy
B
PID
C
Endometriosis
D
Peritonitis
High-Yield Explanation
Ans. is d, i.e. PeritonitisRef: Williams Gynae 1st/ed, p932, COGDT 10th/ed, p801-2Important points to remember on laparoscopy:* CO2 is currently the insufflation gas of choice for laparoscopy. It fulfills most of the requirements for an ideal insufflation gas, being colorless, noninflammable and rapidly excreted from the circulation.Other alternative is N2 O: But it is expensive, less soluble in blood and supports combustion.* Instrument used for creating pneumoperitoneum is vercess needle.* It should be inserted at an angle of 45 degrees to the spine.* Flow rate of CO2 for creating pneumoperitoneum is 200-2000ml/min & pressure between 10-15mm of Hg. In many patients, this correlates with an infusion of 2.5 to 3 litres of gas - Williams Gynae 1st/ed, p934Contraindications of laparoscopyAbsoluteRelative* Intestinal obstructionQ* Previous periumbilical surgeyQ* Generalized peritonitisQ* Cardiac or pulmonary diseaseQ* Massive hemorrhageQ* ShockQ* Cancer involving anterior abdominal wallQ

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