Fortunately, laparoscopic equipment is readily available in any setting. The biggest problem is awareness. Companies that supply instrumentation often target their marketing efforts toward high volume institutions. Good sources of information include laparoscopic periodicals, trade shows, and Internet sites. However, the allure of the latest and greatest can be a double-edged sword. Although the right grasper could save 10 minutes off of a procedure, the best-engineered instrument will not replace proper technique. The most important equipment considerations revolve around multiuse, ergonomics, and patient safety, particularly early in one's experience.

table io ■ Hospital Cost Personnel

Every laparoscopic procedure is a team effort. The key personnel fulfill many functions beyond assisting the surgeon. Every aspect of success is dependent on the behind-the-scenes preparation, whether the day of the procedure or months prior. Input should be constantly recruited from everyone in the room. Key observations and modifications have been developed in this manner.

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