SELF/Perioperative Nursing/Laparoscopy Setup/Psychomotor Skills Practice Instructions
Laparoscopy Setup and Assistance – Perioperative Nursing (ECSACONM)
[edit | edit source]Overview
[edit | edit source]This page provides a psychomotor skills practice guide for laparoscopy setup and assistance, developed for perioperative nursing training under ECSACONM (East, Central and Southern Africa College of Nursing). It is intended as a self-directed developer worksheet, outlining the sequential steps, associated learning objectives ("good skills"), common errors, and practical guidance for preparing, assembling, testing, troubleshooting, and managing laparoscopic equipment.
This practice develops the skills needed to prepare, assemble, test, troubleshoot, and manage laparoscopic equipment in a safe and systematic manner. Perform every task exactly as you would in the operating room, maintaining safe equipment handling, aseptic technique, and effective communication throughout the exercise.
A simulated operating room environment is recommended. A patient can be simulated by placing a pillow, folded blankets, or a mannequin on an operating table or similar surface and covering it with sterile drapes to represent a prepared surgical patient. Position the laparoscopic tower, monitor, and other equipment around the simulated patient as they would be arranged for an actual laparoscopic procedure. This allows realistic practice of equipment positioning, cable management, and ergonomic setup.
This practice requires at least one assistant. The assistant should perform the assistant actions identified in the practice guide, such as helping position equipment, connecting non-sterile components, presenting sterile items, participating in equipment testing, and responding to simulated equipment requests during the procedure. The assistant should also introduce occasional simulated equipment problems, when appropriate, to allow practice of systematic troubleshooting and communication.
NB: Although no real patient is involved, perform every action as though patient safety depends on it. Verify each system before progressing, communicate clearly with your assistant, recognize and correct equipment problems promptly, and maintain an organized, safe working environment throughout the practice session.
Purpose
[edit | edit source]To guide nursing students and practitioners through a systematic, step-by-step process for setting up and assisting with laparoscopic surgery, ensuring equipment readiness and function, aseptic technique, correct assembly and testing of integrated systems, systematic troubleshooting, and effective communication throughout the procedure.
Psychomotor Skills Practice Instructions
[edit | edit source]| # | Step | Assistant (Circulator) | Instructions | Good Skills (Learning Objectives) | Common Errors | Guidance |
|---|---|---|---|---|---|---|
| 1 | Prepare laparoscopic equipment and sterile supplies | State aloud: "I confirm that all required laparoscopic equipment, sterile instruments, trocars, scopes, accessories, cables, tubing, and consumables are available, compatible, sterile where required, and organized before setup begins." | ||||
| 2 | Verify procedure requirements | State aloud: "I review the planned procedure and surgeon's preference card to determine the required laparoscope, instruments, trocars, energy devices, accessories, and any specialty equipment before preparing the system." | ||||
| 3 | Position laparoscopic tower and monitor | Assists with moving and positioning tower. | Position the laparoscopic tower opposite the surgeon on the same side as the operative field. Place the monitor at approximately eye level, secure the tower by locking the wheels, organize all cables, and ensure the equipment does not obstruct movement around the operating table. | You can see that the surgeon has a direct line of sight to the monitor, the tower is stable, wheels are locked, cables are organized without crossing walkways, and the team can move freely around the operating room. | Poor tower position creates awkward viewing angles, tangled cables, trip hazards, or restricted access for members of the surgical team. | Before proceeding, walk around the simulated operating room and confirm that no cable or equipment obstructs movement. |
| 4 | Connect power and perform initial equipment check | N/A | Connect each component to the appropriate power source, verify that cables are intact and securely connected, then power on the equipment in the recommended sequence while observing each system's startup checks. | Each component completes its self-test without error messages, displays normal indicators, and all cables remain secure throughout startup. | Loose cables, incorrect startup sequence, damaged power cords, or ignoring warning messages may result in equipment failure during surgery. | Watch every display during startup. If any warning appears, stop and investigate before continuing. |
| 5 | Assemble, connect, and test insufflation system | Connects CO₂ source if required. | Connect the CO₂ source and tubing, perform the manufacturer's self-test, set the prescribed pressure and flow, verify secure tubing connections, and confirm normal insufflator function before patient use. | The gas source is adequate, tubing is free of leaks or kinks, prescribed settings are displayed correctly, and the insufflator responds normally during testing. | Loose tubing, incorrect pressure or flow settings, depleted gas supply, or ignoring alarms may result in loss of pneumoperitoneum or procedure delays. | Follow the gas pathway visually from the cylinder or wall supply to the insufflator and tubing, confirming every connection in sequence. |
| 6 | Assemble and connect camera system | N/A | Inspect the laparoscope, camera head, and cables for cleanliness and damage. Connect the camera head to the camera control unit, attach the laparoscope and light cable, then verify image quality by performing white balance and focus adjustment. | A clear, correctly oriented image appears on the monitor without flickering, distortion, or interruption. All connections remain secure during testing. | Incorrect cable connections, incomplete assembly, failure to inspect equipment, or skipping image checks produces poor visualization during surgery. | If image quality is poor, check the simplest causes first—connections, contamination, focus, and white balance—before replacing equipment. |
| 7 | Assemble and connect light source | N/A | Inspect the light cable for damage, connect it securely to both the light source and laparoscope, adjust illumination, and route the cable safely to prevent tension or contamination. | Bright, even illumination reaches the laparoscope without flickering, overheating, or cable strain. | Damaged cables, loose connections, excessive cable tension, or unsafe routing may reduce illumination or damage equipment. | Handle fiberoptic cables gently. Avoid sharp bends and keep hot cable tips away from drapes and other equipment. |
| 8 | Assemble suction, irrigation, and smoke evacuation systems | Assists with wall suction and smoke evacuation connections. | Assemble suction and irrigation tubing, connect the tubing to the appropriate ports and fluid sources, prime the system, test suction and irrigation, and maintain sterility throughout setup. | Fluid flows smoothly without air bubbles, suction functions immediately when activated, tubing is secure, and no leaks are visible. | Incorrect assembly, loose tubing, blocked lines, failure to prime the system, or skipping functional testing may interrupt surgery. | Trace every tubing connection from source to handpiece before performing the functional test. |
| 9 | Connect and test energy systems | Assists with foot pedal placement and accessory acquisition. | Assemble the required energy platform and accessories, inspect cables and handpieces, connect foot pedals, verify settings, and safely test activation on an approved test medium. | Equipment passes self-checks, accessories are compatible, settings match procedural requirements, and activation functions normally during testing. | Incorrect settings, incompatible accessories, damaged insulation, or failure to perform activation testing may create patient safety risks. | Read each display before activation and confirm the selected mode matches the planned procedure. |
| 10 | Inspect and organize laparoscopic instruments | Obtains replacements when requested. | State aloud: "I inspect each laparoscopic instrument for completeness, sterility, integrity, insulation defects, smooth articulation, compatibility with the laparoscopic system, and correct arrangement before surgery begins." | |||
| 11 | Establish sterile laparoscopic field | Opens supplies aseptically. | Arrange laparoscopic instruments and equipment on the sterile field using aseptic technique while maintaining sterile boundaries and coordinating with the non-sterile team. | Sterile items remain within the sterile field, instrument organization is logical, and no contamination occurs during setup. | Contaminating sterile items or disorganizing the field increases the risk of delays and breaks in sterility. | Pause after completing setup and visually inspect the entire sterile field for organization and contamination risks. |
| 12 | Drape camera, cables, and sterile equipment | Holds non-sterile portions during draping. | Apply sterile covers to the camera and cables using aseptic technique while protecting the sterile barrier and maintaining equipment function. | Covers remain intact without tears, all non-sterile surfaces remain isolated, and equipment functions normally after draping. | Torn covers, contamination during application, loose seals, or obstructed connections compromise sterility and equipment performance. | Watch the sterile barrier continuously while advancing the cover along the cable rather than focusing only on the equipment. |
| 13 | White balance, focus, and prepare visualization system | Assists with image display if needed. | Perform white balancing using the recommended surface, adjust focus, confirm image orientation, and optimize brightness before surgical use. | The monitor displays a sharp, natural-colored image with correct orientation and no visible distortion. | Skipping white balance, inaccurate focus, or incorrect image orientation reduces visualization during surgery. | Compare the image before and after white balancing to confirm the improvement in colour accuracy. |
| 14 | Perform pre-procedure system readiness check | Assists with troubleshooting if needed. | Verify operation of every integrated laparoscopic system, including video, lighting, insufflation, suction-irrigation, and energy equipment, and resolve any problems before patient arrival. | Every component functions normally, all connections remain secure, and no unresolved alarms or faults remain. | Incomplete testing or failure to identify malfunctioning equipment may result in equipment failure after surgery begins. | Perform the system test using the same sequence every time so that no component is overlooked. |
| 15 | Participate in surgical safety briefing | State aloud: "I confirm laparoscopic equipment readiness, communicate any deficiencies, verify required equipment is available, and raise safety concerns before the procedure begins." | ||||
| 16 | Manage laparoscopic equipment during surgery | Provides supplies and operates non-sterile equipment as requested. | Manage camera equipment, respond to equipment requests, assist with instrument handling, and maintain equipment readiness throughout the simulated procedure. | Equipment remains organized, requested items are provided promptly, and camera and cables remain functional without interrupting the procedure. | Delayed responses, disorganized equipment, or failure to recognize developing equipment problems disrupt surgical flow. | Maintain awareness of the |
| Authors | Ian-laurel |
|---|---|
| License | CC-BY-SA-4.0 |
| Organizations | SELF, ECSACONM |
| Cite as | Ian-laurel-1 (2026). "SELF/Perioperative Nursing/Laparoscopy Setup/Psychomotor Skills Practice Instructions". Appropedia. Retrieved July 30, 2026. |