Laparoscopic Abdominal Pelvic Anatomical Landmarks and Essentials of Surgical Exploration

In conventional open surgery, the surgeon carries out the operation depending on the visualization and haptic sensations of the affected tissue directly. With the continuous development of the laparoscopic technique, this conventional surgical procedure has been greatly challenged. Both conventional and laparoscopic surgeries show tremendous differences in the entire process of surgical operation. However, the evaluation, identification, and application of anatomical landmarks are indispensable in both procedures. In the evaluation of anatomical structures, unlike open surgery, laparoscopic surgery lacks the benefit of haptic sensations, but it still exhibits obvious advantages in various other aspects. For instance, as compared to open surgery, laparoscopic exploration is less invasive as only a single trocar is inserted for the exploration of the abdominal and pelvic cavity. In addition, it gives the surgeon a better view and a wider surgical field to thoroughly explore the organs in the above-mentioned cavities by adjusting the position and angle of the camera. Furthermore, the amplification effect of laparoscopy helps the surgeon to identify the anatomical structures and the condition of lesions, especially to observe and secure small blood vessels and nerves. What is more, the laparoscopic procedure enhances the learning process as it is much more convenient to watch and observe. These advantages of the laparoscopic technique over open surgery make it a better alternative to conventional open surgery. However, there are several shortcomings of laparoscopic surgery, including relatively strict surgical indications, lack of haptic sensations, and difficulties in locating obscure lesions within the abdominal organs (such as small intestines, mesentery, omentum, and liver parenchyma). In this chapter, we have demonstrated the basic anatomy of the abdomen and pelvis with the high-definition pictures taken intraoperatively, to explain the anatomical structure and essentials for laparoscopic exploration from a new perspective.