Outpatient Surgery Magazine

Abdominal Surgery Supplement - March 2013

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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M I N I - L A P IMPROVED EXPOSURE Smaller Holes, Safer and Faster Surgery hat do all laparoscopic case have in common? They all begin with cameras inserted through a port of entry, so surgeons can assess surgical cavities and plot their next moves. That means they shouldn't commit to specific approaches before gaining access to the abdomen — they might find they're able to complete the procedure through a single port, with standard 5mm instruments placed through multiple trocars, or with a combination of conventional and minilap instrumentation maneuvered through 5mm and 3mm holes. The most immediate and practical application of mini-lap's smaller holes is their use in combination with 5mm trocars or during reduced-port techniques. Whether used alone or in combination with standard instrumentation, mini-lap leads to potentially safer surgeries because it gives surgeons better exposure to the surgical cavity. Surgeons married to reduced-port techniques, however, sometimes hesitate to add an extra trocar because of scarring concerns, even if the addition- W 1 4 WAIT AND SEE Surgeons must adapt to what they find within the abdomen instead of committing fully to a technique. al port would make the surgery easier to perform. But most surgeons wouldn't mind making 3mm nicks that patients won't notice in order to use a mini-lap instrument, meaning they're more likely to use the tools that can lead to safer and faster operations. Inserting a minilap instrument through a minute skin incision to lift the gallbladder and achieve better exposure can mean the difference between making a challenging case more manageable and wasting valuable surgical time — or worse — harming the patient. — Paul G. Curcillo II, MD, FACS O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | M A R C H 2013

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