Benefits And Limitations

Minilaparoscopy is associated with a cosmetic advantage compared to conventional laparoscopy in which, port site incisions vary from 5-15 mm. A retrospective study comparing needlescopic and conventional laparoscopic adrenalectomy demonstrated lesser postoperative pain, decreased length of stay in the hospital, and a shorter convalescence associated with needlescopic surgery. Also, patients undergoing minilaparoscopic procedures can often be treated on an outpatient basis or in an office setting (8). Moreover, diagnostic minilaparoscopic procedures may be performed under local anesthesia, making this a versatile tool in the office or emergency/trauma room.

Minilaparoscopic instruments are ideally suited for handling finer structures and fine sutures, making them optimal for performance of delicate reconstructive laparo-scopic procedures.

Compared to 5 and 10 mm laparoscopes utilized for conventional laparoscopy, image resolution with the minilaparoscopes is inferior. The minilaparoscopes have a short focal distance, and as a result need to be placed closer to the target object compared to conventional laparoscopes. This results in transmission of an image that is too bright. Minilaparoscopic instruments lack tensile strength and are not as sturdy as conventional laparoscopic instruments. As a result, this makes the performance of major ablative procedures rather cumbersome. Another limitation with minilaparoscopy is the limited selection of instruments presently available. These include the lack of some instruments that are essential to effectively performing any laparoscopic case including clip applicators, energy-based hemostatic devices, effective suction-irrigation systems, tissue retractors, and improved tissue-handling graspers.

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