Outpatient Surgery Magazine - Subscribers

OR Excellence Awards 2015 - September 2015 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://magazine.outpatientsurgery.net/i/567827

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Page 115 of 168

conventional laparoscopic surgery is modest. Should you be encouraging your surgeons to take the big step to incisions so small, you don't need to close them, except at the skin level (or recruiting surgeons who've already downsized their inci- sions), while promoting the twin benefits of less pain and virtually imperceivable scarring to a public that's bound to be intrigued? Here are some factors to consider. Easy learning Unlike single-incision surgery or the NOTES (natural orifice translu- menal endoscopic surgery) approach, the setup for micro-lap surgery is the same as it is for standard laparoscopy, so you don't have to modify your technique tremendously and the technique on the whole is much easier to teach. The small learning curve arises from the fact that you have to be more precise about where you put your trocars and more careful about their trajectory. This is important because poorly placed microlaparoscopic instruments can't withstand a lot of force in the abdominal wall that might be needed to counteract bad placement. They may even bend if you persist in fighting. The good news is they can be repositioned with minimal trauma. Incidentally, some use the terms micro- or mini-laparoscopic surgery interchangeably with the term needlescopic surgery, but there's a dif- ference, and I believe micro-lap with a trocar is safer than needlescop- ic surgery because micro-lap instruments aren't sharp. Needlescopic surgery relies on the sharpness of the instrument to obviate the need for a trocar. Numerous opportunities Cholecystectomies and appendectomies are the procedures most com- monly associated with the micro approach, but I've used it in a variety 1 1 6 O U T P A T I E N T S U R G E R Y M A G A Z I N E O N L I N E | S E P T E M B E R 2 0 1 5

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