M I N I - L A P
techniques; they perform laparoscopy as they're accustomed to doing, but with 2.5mm and 3mm instruments inserted through like-sized trocars. Having the option to operate through smaller holes instead of 5mm ports is hugely valuable. For example, surgeons might find it difficult to manipulate organs while maneuvering instruments through standard trocars, but by popping a mini-lap instrument through a small incision, they're able to retract organs or tissue and hold it in place without adding another port. Mini-lap can be a much safer technique than suture retraction because surgeons aren't inserting sharp instruments into the abdominal cavity to secure anatomy.
Surgeons must perform cases quickly and safely, regardless of technique, and mini-lap can help meet those goals. A surgeon struggling through a difficult lap chole can insert a mini-lap grasper into the abdomen's upper-right quadrant to retract the gallbladder, which helps the case go faster. My colleague, Stephanie King, MD, director of minimally invasive gynecologic surgery and post-graduate training here at Fox Chase Cancer Center in Philadelphia, will sometimes insert a mini-lap instrument into the lower-left or lower-right quadrant — or both — to lift an ovary for better exposure and improved, faster dissection.
For patients, the cosmetic benefits of mini-lap are obvious. In most cases you don't have to cover the 3mm ports with bandages after surgery; applying a small amount of adhesive wound-sealing glue renders scars nearly invisible.
