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the miniaturized instruments that's different. "All you've done is remove 2 5mm
trocars as well as post-op sutures," says an industry rep. The beauty of mini-lap
is that surgeons don't need to learn new techniques. They perform laparoscopy
as they're accustomed to doing, but with 2.5mm and 3mm instruments inserted
through like-sized trocars, says surgical oncologist Paul Curcillo II, MD, FACS,
of Fox Chase Cancer Center in Philadelphia, Pa.
The benefits of operating through smaller holes instead of 5mm ports? Access
and safety, says Dr. Curcillo. Let's say your surgeons struggle to manipulate
organs while maneuvering instruments through standard trocars. By inserting 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 also can be a
much safer technique than suture retraction because surgeons aren't inserting
sharp instruments into the abdominal cavity to secure anatomy, a real concern
in patients with a history of adhesions. "We automatically offer small scopes to
patients with severe adhesions," says Vangie Dennis, RN, BSN, CNOR, CMLSO,
administrator of the Spivey Station Surgery Center in Jonesboro, Ga. "The last
thing you want to do with a patient with adhesions is go in with a 10mm instru-
ment."
2. Which procedures are best suited for mini-
laparoscopy?
When does it make most sense to reduce the number and
the size of the operating ports and instruments? We put that question to a panel
of 21 readers, and all but 1 mentioned laparoscopic cholecystectomies and
appendectomies. Mini-lap is also especially beneficial for such procedures as
ovarian cyst removal, tubal ligation, and biopsies of the pancreas and liver, our
panelists say.
Perhaps mini-lap's greatest benefit is letting you perform purely diagnostic
procedures via a single puncture site, says Ms. Dennis. Take the patient with
non-specific abdominal pain, she says. "With mini-lap, you can get a safe view of
what's going on. You can always switch to conventional instruments if you have
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