SMALL-DIAMETER LAPAROSCOPY (SDL) USING A MICROLAPAROSCOPE

Purpose: To determine the ability of new sub-20-mm-diameter microlapar oscopes to be used for diagnostic laparoscopy, 28 small-diameter lapar oscopies (SDL) were performed during a 4-month-period. Methods: These cases were performed under general anesthesia, with immediate follow-u p confirmation with conventional laparoscopic equipment. An additional 13 SDL procedures were performed under analgosedation plus local anes thesia and were well tolerated by the patients. Results: For the cases performed with conventional laparoscopic control, the visualization r esults were comparable in 27 of 28 procedures. In the nongeneral anest hesia SDL group, patients were highly satisfied and reported less post procedural discomfort and minimal scar formation due to the smaller ac cess ports. In this study, two types of microlaparoscopes were used. C onclusions: While both were adequate, the newer high-resolution microl aparoscope delivered an image much more similar to that which conventi onal laparoscopy and required little or no change in technique in orde r to obtain images. With the advent of this new endoscope technology w ith optics performance comparable to that of conventional laparoscopes , SDL has demonstrated to be a useful procedure for certain clinical i ndications.