The laparoscopic suction irrigator, also known as the suction-irrigator, has the most basic function of both suction and irrigation. Although these two operations seem simple, it takes repeated practice to master them. Beginners often struggle with the device, either causing a rapid drop in abdominal pressure as soon as it enters the cavity, or sucking in surrounding tissues at the beginning of the suction process, which can affect the smooth progress of the surgery.
Suction: When rinsing the pelvis with fluid, the front opening of the laparoscopic suction irrigator should not be submerged too deeply into the liquid. It is better to just touch the surface of the fluid and then move the device forward slowly as the fluid level drops. This way, tissue around the suction head can be seen, and the umbrella end of the fallopian tube or omentum tissue can be prevented from being sucked in and blocking the device. In cases of pelvic hematoma in ectopic pregnancy with a lot of blood accumulation, the suctioning rod's cavity near the front metal tube is small, so the blood clots can easily block it. At this time, the suctioning rod can be removed, and the metal tube at the front of the suction device can be directly connected to a plastic suction tube for faster suctioning. Similarly, when suctioning a small amount of oozing blood, continuous suction should be avoided to prevent a drop in abdominal pressure. Instead, quick suction and quick release should be used to remove the oozing blood while also inflating for a certain amount of time to avoid a drop in abdominal pressure.
Irrigation: The method of using the laparoscopic suction irrigator for irrigation depends on the purpose. When rinsing the abdominal cavity after surgery or cooling the surrounding tissues of the ureter during separation, it is best to simply use a large suction device. However, to expose smaller oozing points, gentle flushing or even dripping water is required. Once the bleeding spot is exposed, quick electrocoagulation can be used to stop the bleeding.
Blocking: For example, blocking blood vessels. When removing lymph nodes and exposing the iliac vessels, using the suction device to block the veins is safer than using a separation clamp;
Pressure: For example, applying pressure to the colon. Due to its large contact area with tissue, it is not easy to damage fragile tissues such as the intestinal wall;
Picking: By lifting up the pudendal nerve, it can help to remove lymphatic tissue from below the pudendal nerve plane. By lifting up the inguinal ligament, it can expose the pudendal fossa, as well as the deep inguinal lymph nodes;
Separation: The suction device is also useful in blunt separation of adhesions. While separating adhesions, it can also suck out any oozing blood, which helps to expose the potential gap in the adhesion and find the direction to move forward.