There are days when laparoscopic surgery is a breeze. The anatomy is perfect. The view is beautiful. Your assistants are thinking three steps ahead of you. In other words, the way surgery happens in your dreams
And then there are days when it isn’t going that way. The anatomy is distorted and confusing. There is bleeding that continuously distort your view. Your assistants are struggling. You are quickly becoming unhappy and want nothing more than for the surgery to be over and the patient to be well.
I have had many of both kinds of days. Over the years I have been operating, I have identified a few things that tend to have happened on the latter kind of days, and hope to pass a few of those things on. So if you find yourself struggling with laparoscopy, consider whether one of these things is going on.