Outpatient Surgery Magazine

OR Excellence Awards 2015 - September 2015 - Subscribe to Outpatient Surgery Magazine

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

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graspers and dissec- tors at the ends of micro tools may not be sturdy enough to move thick tissue or anatomy. With heav- ier tissue, smaller instruments are bet- ter at pulling than pushing. As such, in some micro-lap pro- cedures, you may also need to augment with standard-sized tools that require larger incisions. For example, for suturing you still need a trocar you can fit a needle through (unless you pass the needle through the abdominal wall, which can be tricky). With many micro procedures, I end up also using some larger trocars, either to take something out or to put something in. Creating comfortable handles seems to be another challenge. But in an increasingly competitive arena, manufacturers are also working to make handles more comfortable by, among other things, providing micro-sized instruments that attach to standard-sized lap handles. Although there's a significant capital expense associated with instru- ment sets that contain the complete array of smaller tools, in the long run micro-laps can save money, because unlike standard disposable trocars, micro-lap ports are reusable. One other caution: I don't do much cleaning of instruments, but I rec- ognize that smaller instruments may be more challenging to clean and service than standard instrumentation. The channels are tiny, so finding small enough brushes can be a challenge, as can adequate flushing. 1 2 0 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 z QUICK STUDY The learning curve for using smaller microlaparoscopic instruments is modest for anyone already well versed in conventional laparoscopic surgery. Pamela Bevelhymer, RN, BSN

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