DIRECT INSERTION OF LAPAROSCOPIC INSTRUMENTS AT MINIMALLY INVASIVE SURGERY - AN ALTERNATIVE TO THE USE OF A TROCHAR AND CANNULA

It has been routine practice at laparoscopic surgery that laparoscopic instruments be introduced into the peritoneal cavity via specially de signed cannulae at standard sites. These allow easy manipulation of th e instruments and replacement by others if necessary. There are, howev er, several disadvantages with the use of such trochars and cannulae a nd it may not be necessary to use them in all cases. This study was co nceived to test the feasibility of using 5 mm laparoscopic instruments at laparoscopic cholecystectomy, introduced directly into the periton eal cavity without the preliminary placement of a sharp trochar and ca nnula. It was found that in 10 laparoscopic cholecystectomy cases, cer tain laparoscopic instruments of a particular design could, after maki ng a small skin incision, be easily introduced directly into the perit oneal cavity and used to grasp and manipulate the fundus and infundibu lum of the gall bladder as at conventional laparoscopic cholecystectom y. There were no complications.