For what reason may a hand-assisted access sleeve be used in a laparoscopic procedure?

a. To keep the surgeon's hands warm during the procedure
b. To allow insertion of the surgeon's hand to palpate or grasp an organ
c. To place pressure on a vessel that is bleeding
d. To lose the peritoneum and convert to an open procedure

ANS: B
A hand-assisted access sleeve is required if the surgeon needs a tactile sense for diagnosis or excision of a large organ that cannot be attained by endoscopic instruments alone. The surgeon can make a small 3-inch incision and insert a sterile inflatable or gel sleeve through which he or she can insert a hand into the abdomen without losing the pressurized field. After sleeve assembly is placed in the incision, pneumoperitoneum can be established. Organs can be palpated or grasped by hand and removed.