Microlaparoscopy: An Uncomplicated Alternative to NOTES and SILS

Microlaparoscopy: An Uncomplicated Alternative to NOTES and SILS

INTRODUCTION:

The recent quest to advance laparoscopy and to diminish incisions had led to the developments of NOTES, and more recently SILS (Single Incision Laparoscopic Surgery.) Both methods have increased the complexity of surgical procedures and inherently require a high level of surgical skills. We have explored microlaparoscopy as a simpler alternative to NOTES or SILS.

METHODS:

This is s retrospective review of cases performed by a single surgeon at a single university hospital over the course of 12 months. Microlaparoscopy was performed on 425 cases using all 3 mm 45 degree laparoscopes and trocars in the usual configurations. A single larger port was used for stapling when necessary.

RESULTS:

All cases were completed with the mentioned trocar configuration. No cases were converted to open or upgraded to larger trocars.
These cases crossed the entire general surgery spectrum including 98 gastric bypasses, 30 gastric bands, 71 TEPs, 50 ventral hernias, 58 cholecystectomies with cholangiograms, 5 adrenalectomies, 35 hiatal hernia/reflux procedures, 17 bariatric revisions, 2 colectomies, 3 Heller myotomies, 6 gastric resections, 3 splenectomies/pancreatectomies and 2 splenic artery aneurysm resections. There were no intra-operative complications related to the use of 3mm trocars/instruments.

CONCLUSION:

Microlaparoscopy is safe and feasible across the whole spectrum of laparoscopic general surgery. Technological advancements in visualization and the use of advanced microlaparoscopic instruments have enabled the development of this technique. Microlaparoscopy is simply an extension of current laparoscopic techniques. Unlike NOTES or SILS this technique does not require surgeons to acquire new skills, and therefore is widely applicable. Microlaparoscopy represents an uncomplicated alternative to NOTES and SILS.


Session: Podium Presentation

Program Number: S027

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