Lesson 1Anticipating surgeon needs at key operative stages: exposure of Calot’s triangle, identification of cystic duct and artery, clipping and division, gallbladder dissection and retrievalLooks at guessing surgeon needs in main stages: opening the area, cutting Calot’s triangle, finding cystic parts, clipping and cutting, and helping with gallbladder cutting, taking out, and sample handling.
Instrument needs for initial exposureSupport during Calot’s triangle dissectionPreparation for clipping and divisionAssisting gallbladder dissection stepsSpecimen retrieval and bag handlingLesson 2Communication and closed-loop technique in theater: assertive communication, calling out counts, reporting unexpected findings, speaking up about safety concernsCovers planned talking in the operating room, stressing closed-loop method, strong but kind words, calling counts and key steps, raising surprise findings, and saying safety worries without delay.
Principles of closed-loop communicationStandardized calls for key stagesCalling and confirming instrument countsEscalating unexpected intraoperative findingsSpeaking up about safety concernsLesson 3Instrument handling and passing principles: neutral zone, finger-ring technique, one-hand vs two-hand passes, ergonomic positioningExplains safe holding and giving of laparoscopic tools, stressing neutral area use, finger-ring hold, one-hand vs two-hand giving, easy body position, and ways to cut tiredness and sharp or crush hurts.
Neutral zone setup and use in laparoscopyFinger-ring and hand grip controlOne-hand versus two-hand instrument passesErgonomic posture at the scrub trolleyPreventing sharps and crush injuriesLesson 4Use of energy devices and smoke management: bipolar/monopolar diathermy, ultrasonic devices, plume evacuation protocols and PPECovers safe use of single, double, and sound wave energy tools, including setup, safe starting, stopping stray burns, and good smoke removal with right PPE to cut team smoke risks.
Monopolar and bipolar diathermy setupUltrasonic device indications and checksActive electrode and cable safetySmoke evacuation systems and settingsPPE for surgical plume exposure controlLesson 5Managing intraoperative sterility breaches and complications: immediate actions for gown/glove breach, contamination of instruments, suspected bile leak or hemorrhage, calling for senior helpDeals with spotting and handling clean breaks and surgery problems, like gown or glove tears, dirty tools, suspected bile leak or bleeding, and quick call to senior staff and records.
Detecting gown and glove breachesResponding to contaminated instrumentsActions for suspected bile leakInitial response to intraoperative bleedingEscalation pathways and documentationLesson 6Sharps handling and safety devices: needle handling, sharps counters, use of safety scalpels and blunt needles, immediate disposal protocolsOutlines safe sharp tool handling in laparoscopy, like needle loading, sharp counters, safe knives and dull needles, neutral giving, and quick throw away to cut needle stick and cut hurts.
Sharps risk assessment in laparoscopyNeedle loading and unloading safelyUse of sharps counters and traysSafety scalpels and blunt needle useImmediate sharps disposal protocolsLesson 7Patient positioning and pressure area protection: supine/tilt considerations, securing the patient, padding, table tilt for exposureLooks at safe back-lying and tilt placing for laparoscopic cholecystectomy, including tying the patient, guarding pressure spots, best table tilt for view, and watching body changes during moves.
Supine and reverse Trendelenburg principlesSecuring the patient and limb supportsPressure area assessment and paddingTable tilt for optimal surgical exposureMonitoring hemodynamic and respiratory effectsLesson 8Trocar insertion assistance and safe insufflation: sequencing of ports, Veress vs open/Hasson technique overview, insufflation pressures and monitoringReviews help with port putting in and belly gas fill, including port order, Veress vs open ways, safe gas pressure, watching patient reaction, and fixing alarms or gas leaks.
Port site planning and sequencingAssisting Veress needle insertionAssisting open or Hasson entryInsufflation pressures and flow ratesMonitoring for gas leaks and alarmsLesson 9Skin preparation and draping for laparoscopic cholecystectomy: antiseptic choice and technique, timed drying, adhesive drapes, port site positioning and protection of non-sterile areasDescribes skin cleaning and covering for laparoscopic cholecystectomy, like choosing germ killer, cleaning way, dry times, sticky covers, port marking, and guarding unclean areas from liquid soak.
Antiseptic agent choice and allergiesSystematic abdominal prep techniqueTimed drying and fire risk reductionDrape selection and adhesive sealingPort site marking and access windowsLesson 10Establishing and maintaining the sterile field: sterile field setup, transfer of sterile items, maintaining distance, monitoring for breachesExplains setting up and keeping a safe clean area, including laparoscopic tool layout, giving clean items, keeping distance from unclean spots, and always watching for dirt or breaks.
Sterile field layout for laparoscopyOpening and transferring sterile itemsMaintaining distance from non-sterile zonesIdentifying and managing field breachesDocumentation of contamination events
