Background: Several issues have limited the widespread adoption of transanal endoscopic microsurgery (TEM). The need for specialized equipment and the steep learning curve represent one of them. To operate on within a 4-cm diameter, rectoscope represents a major technical challenge. However, minilaparoscopic surgery has been introduced to reduce invasiveness and abdominal wall trauma. In TEM, instrument miniaturization may lead to technique optimization. We hypothesized that visualization and maneuverability during TEM performed with 3-mm minilaparoscopic instruments would be superior to TEM performed with conventional 5-mm instruments.
Methods: Eighteen general and colorectal surgeons with experience with TEM under ten cases were recruited. Two tasks should be accomplished using the TEO(®)-Neoderma simulator. First, using conventional 5-mm TEO(®) curved-tip instruments, a "polypoid lesion" should be excised. Next, closure of the "rectal" defect should be undertaken. In the second part, the same participants repeated the same excision/closure tasks using 3-mm minilaparoscopic instruments. After tasks conclusion, participants fulfilled an evaluation questionnaire with seven questions regarding visualization and maneuverability when using 3-mm compared to 5-mm instruments.
Results: For each one of the seven questions in the questionnaire, the score results were significantly higher for the 3-mm instruments indicating that performance with the 3-mm minilaparoscopic instruments in the TEO simulator was in all cases between "better than expected" and "much better than expected." Appropriateness of the diameter of the minilaparoscopic instruments was the best evaluated parameter. The question addressing the ease of performing the tasks in the simulator presented the lowest mean score.
Conclusions: The perceptions of participating surgeons indicated that there is better visualization and maneuverability during basic transanal endoscopic microsurgery tasks conducted in a simulator using 3-mm minilaparoscopic instruments when compared to conventional 5-mm instruments.
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http://dx.doi.org/10.1007/s00464-014-3956-1 | DOI Listing |
Surg Technol Int
November 2022
Global Hospitals < Mamata Hospital, Mumbai, India.
As the world sought the 'Holy Grail' of scarless surgery, minimizing access seemed to be the natural path to follow, and minilaparoscopy (MINI) was considered to be a natural advancement of standard laparoscopy. It aims at minimizing surgical trauma by further reducing the diameter of standard instruments, without compromising range of motion, triangulation or safety. Several different terms have been coined to address this sophisticated reduced-port technique, which is characterized by the use of instruments 3 mm or less in diameter: acuscopic surgery, minilaparoscopy, needlescopic surgery and microlaparoscopy.
View Article and Find Full Text PDFGynecol Obstet Invest
January 2023
Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain.
Objectives: Laparoendoscopic single-site surgery (LESS) and mini-laparoscopic surgery (Mini-LPS) have been performed with comparable results to conventional laparoscopy. However, there are few data on the comparison between them. Our main objective was to compare LESS and Mini-LPS in terms of surgical time, postoperative pain, and hospital stay in patients who underwent hysterectomy for benign pathology.
View Article and Find Full Text PDFSurg Endosc
October 2022
Department of Surgery, The University of Chicago, Chicago, IL, USA.
Background: The TAVAC and Pediatric Committees of SAGES evaluated the current use of mini-laparoscopic instrumentation to better understand the role this category of devices plays in the delivery of minimally invasive surgery today.
Methods: The role of mini-laparoscopic instrumentation, defined as minimally invasive instruments of between 1 and 4 mm in diameter, was assessed by an exhaustive review of the peer reviewed literature on the subject between 1990 and 2021. The instruments, their use, and their perceived value were tabulated and described.
J Vasc Bras
May 2020
Amiri Hospital, Department of Surgery, Kuwait.
Severe palmoplantar hyperhidrosis affects about 1.5-2.8% of the general population.
View Article and Find Full Text PDFMinerva Obstet Gynecol
April 2021
Department of Gynecology and Obstetrics, F. Del Ponte Hospital, University of Insubria, Varese, Italy.
The word "minilaparoscopy" refers to laparoscopic surgical procedures performed using <5-mm trocars, with the exception of the umbilical access. The aim of this review is to explore the feasibility of minilaparoscopy in gynecologic surgery, focusing on instruments, surgical techniques, application and limits of this approach. In this review the authors discussed the positive features and limitation of 3-mm laparoscopy for gynecologic surgery.
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