Fig. 1.2    Conventional  setup  for  upper  GI  surgery.  S surgeon;  FA first  assistant;  CA  camera  assistant

Setup for Lower Abdominal Surgery

For noncolorectal procedures the patient can be placed in a supine position without spreading the legs. In colorectal procedures the patient is placed in a modified Lloyd Davies position with the legs spread. An important aspect here is to make sure that the surgeon can circulate freely, and is able to move from one side of the patient to the other without obstruction from the instrumentation table, or electrocautery, or suction devices.

The monitor is positioned at the feet of the patient for hernia procedures (Fig. 1.3), but for a laparoscopic appendectomy the monitor is placed at the right side of the patient with the surgeon facing the TV monitor (Fig. 1.4). For left sided colorectal procedures, an additional monitor is placed at the patient’s left shoulder to allow surgeon visualization when the splenic flexure of the colon is mobilized (Fig. 1.5). The same applies for the right colon and its hepatic flexure, where the monitor should be near the patient’s right shoulder (Fig. 1.4).

For laparoscopic hernia repair, it is advised to tuck in both the patient’s arms and prepare the patient so the surgeon can alternatively stand on the left or the right.

For laparoscopic appendectomy, the left arm of the patient should be tucked in to allow the surgeon and assistant to stand comfortably on the left side.