2. Mini tools aren't sturdy.
Some say the instruments are too
flimsy, that they're going to bend
or even break. That's not true, as
long as you use them properly.
Twenty years ago, when we start-
ed doing laparoscopy, instruments
were about 10 or 12 mm. Then,
roughly a decade later, as the met-
als got better and the instrumenta-
tion got sturdier, we started seeing
and using 5 mm tools. Now, those
of us who are proficient at mini-
lap are using 2 and 3 mm instru-
ments. Combined with the stabili-
ty and strength of the trocars we use with them, they've become
much more robust. Improved trocars play a big role, too. Now
they're made of titanium and they actually match the size of the
instrumentation better. They provide stability in the abdominal wall,
so the instruments don't bend or break the way they did 10 or 15
years ago. And instruments are getting better all the time.
Manufacturers have caught on that mini-lap isn't just a fad. Where
there used to be just one company making mini instruments, now
there are several, and the competition is continually improving the
instruments.
3. It's difficult to master. Actually, the reverse is true: Mini-lap is rel-
atively easy to master. Having taught many other surgeons, I've seen
again and again that as long as you're adept at standard laparoscopy, you
typically need 10 cases or fewer to master mini-lap. Usually, once sur-
J U L Y 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 6 5
• BARELY LEFT A MARK People like to show off pictures of themselves on social
media sites after having mini-lap surgeries.
Gustavo
Carvalho,
MD,
PhD
