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Geraldo José DE Souza Lima, Rodrigo Fabiano Guedes Leite, Gustavo Munayer Abras, Livio José Suretti Pires, Eduardo Godoy Castro
The role of laparoscopy in the modern surgery era is well established. With the prospect of being able to improve the already privileged current situation, new alternatives have been proposed, such as natural orifice endoscopic surgery (NOTES), the method for single transumbilical access (LESS - Laparo-endoscopic single-site surgery) and minilaparoscopy (MINI). The technique proposed by the authors uses a laparoscope with an operative channel like the flexible endoscope used in NOTES. All operative times are carried out through the umbilical trocar as in LESS, and assisted by a minilaparoscopy grasper...
May 2016: Revista do Colégio Brasileiro de Cirurgiões
Alyssa Small Layne, Lauren Pinkard, Jessica Shepherd
PURPOSE OF REVIEW: The purpose of this review is to understand the current use of minilaparoscopy in the field and how minilaparoscopy compares with traditional laparoscopy in terms of operative times, complications, pain, and cosmesis. RECENT FINDINGS: Although there are few randomized controlled trials comparing minilaparoscopy with traditional laparoscopy in gynecologic procedures, the results suggest that minilaparoscopy can be performed safely with improved cosmetic outcomes and similar complication rates and operating times...
August 2016: Current Opinion in Obstetrics & Gynecology
Lúcio Américo Della Coletta, Bruno Ziade Gil, Renato Morato Zanatto
BACKGROUND: Minilaparoscopy is considered one of the minimally invasive options available for acute appendicitis treatment, although not always employed in less complexity public health services. AIM: Report surgical outcomes of minilaparoscopy use in acute appendicitis treatment. METHOD: The study included 21 patients undergoing minilaparoscopic appendectomy with instrumental of 3 mm. The following variables were analyzed: sex, age, body mass index, stage of appendicitis, surgical time, hospital stay, surgical complications, conversion rate to conventional laparoscopy or laparotomy, pain after surgery and aesthetic result...
March 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Alberto Breda, Pietro Castellan, Rui Azevedo Freitas, Ivan Schwartzmann, Jesus Luis Álvarez Osorio, Josè Heriberto Amón-Sesmero, Josè Antonio Bellido, Enrique Ramos, Diego Rengifo, Juan Antonio Peña, Humberto Villavicencio
OBJECTIVE: To investigate the role of contemporary minilaparoscopy (ML; 3 mm instruments and laparoscope) and to identify predictive factors for complications in a prospective multicenter series for renal and adrenal surgeries. MATERIALS AND METHODS: From July 2013 to December 2014, 110 patients from 6 laparoscopic Spanish centers were enrolled. A common database was used and data were collected in a prospective manner. Standard approach was defined as 3 to 4 3-mm trocars with a 3-mm laparoscope and 3-mm instruments (Karl Storz, Tuttlingen, Germany)...
June 2016: Urology
Hélder Ferreira, Carlos Ferreira, Cristina Nogueira-Silva, Antonio Tomé, Serafim Guimarães, Jorge Correia-Pinto
INTRODUCTION AND AIMS: We aim to compare clinical and surgical outcomes between minilaparoscopic sacrocolpopexy (MLSC) and conventional laparoscopic sacrocolpopexy (LSC). As far as we know, no comparative study exists between these two minimal invasive procedures to correct vaginal prolapse. DESIGN AND SETTING: An observational and comparative study with 20 individuals submitted to vaginal vault prolapse correction between June and December of 2014 in our tertiary referral unit...
May 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Hélder Ferreira, Cristina Nogueira-Silva, Alice Miranda, Jorge Correia-Pinto
Background The sentinel lymph node (SLN) concept might minimize surgical aggressiveness in cervical and endometrial malignancies. The aim of the study was to test the feasibility and reliability of minilaparoscopic extraperitoneal SLN excision after indocyanine green (ICG) cervical injection using a high-definition near infrared (NIR) imaging system in an in vivo porcine model. The same procedure was performed using conventional laparoscopic instruments and both outcomes were compared. Methods Twenty-four animals were equally and randomly divided into a minilaparoscopic group (group A) and a 5-mm conventional laparoscopic group (group B)...
August 2016: Surgical Innovation
Julietta Chang, Mena Boules, John Rodriguez, Matthew Kroh
BACKGROUND: The most common paradigm in minimally invasive surgery is entry of a single trocar through separate incisions in the abdomen. However, in an effort to decrease postoperative pain and minimize scarring, alternative techniques have been described. Needlescopic surgery uses instruments that are 3 mm or less in diameter. Prior uses of needlescopic instruments have been hindered somewhat by diminished shaft strength and small end-effector size. The Percuvance™ (Teleflex, Wayne, PA) system uses a 2...
January 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Wood A Firme, Gustavo L Carvalho, Diego L Lima, Vladmir Goldstein de Paula Lopes, Isabelle D Montandon, Flavio Santos Filho, Phillip P Shadduck
BACKGROUND AND OBJECTIVES: Therapeutic laparoscopy was incorporated into surgical practice more than 25 y ago. Several modifications have since been developed to further minimize surgical trauma and improve results. Minilaparoscopy, performed with 2- to 3-mm instruments was introduced in the mid 1990s but failed to attain mainstream use, mostly because of the limitations of the early devices. Buoyed by a renewed interest, new generations of mini instruments are being developed with improved functionality and durability...
July 2015: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Cristiano Rossitto, Salvatore Gueli Alletti, Barbara Costantini, Francesco Fanfani, Giovanni Scambia
STUDY OBJECTIVE: To highlight the first case of laparoscopic hysterectomy performed with percutaneous instruments (The Percuvance System, Teleflex Incorporated, Wayne, PA). DESIGN: The basis of the system is a <3-mm diameter shaft that, when connected to an introducer tool tip, can be inserted percutaneously through the skin. The introducer tool tip can then be exchanged outside the body for a wide variety of 5-mm interchangeable surgical tool tips. The shaft is sufficiently strong to hold structures, and surgeons can use its interchangeable tool tips to grasp, cut, and manipulate tissue...
January 2016: Journal of Minimally Invasive Gynecology
Nasser Simforoosh, Seyed Hossein Hosseini Sharifi, Reza Valipour, Behzad Narouie, Mohammad Reza Kamranmanesh, Mohammad Hossein Soltani
PURPOSE: This study was conducted to compare safety, efficacy and cosmetic outcome between standard laparoscopic live donor nephrectomy (sLDN) and mini-laparoscopic donor nephrectomy (mLDN) in a randomized clinical trial. MATERIALS AND METHODS: From March 2012 to June 2013, 100 consecutive kidney donors were randomly assigned to two equal groups for laparoscopic donor nephrectomy. mLDN: Six to eight centimeters Pfannenstiel incision was made slightly above pubis symphysis and 11 millimeters trocar was fixed through exposed fascia using open technique...
July 2015: Urology Journal
Fabio Ghezzi, Maurizio Serati, Jvan Casarin, Stefano Uccella
BACKGROUND: Laparoendoscopic single-site surgery and minilaparoscopy (ie, the use of 3-mm instruments) represent two of the most recent advances in ultraminimally invasive surgery. We have combined these two techniques and transvaginal cuff closure to develop a technique for the performance of single-incision, transumbilical, minilaparoscopic hysterectomy. TECHNIQUE: The complete endoscopic detachment of the uterus from its supports and vessels is performed using only two 3-mm minilaparoscopic trocars, both inserted in the umbilicus, with the aid of a uterine manipulator...
July 2015: Obstetrics and Gynecology
Victor T Dubeux, Fabricio Carrerette, Gustavo Peçanha, Lucilio Medeiros, Pedro Gabrich, José Milfont, Ronaldo Damião
PURPOSE: The use of minilaparoscopic instruments has gained interest in recent years, permitting a less invasive treatment for many surgical procedures. Its application in urological surgeries has not been established yet. METHODS: Between November 2012 and December 2014, 32 patients underwent minilaparoscopic surgeries, using 3.5-mm instruments. The procedures performed included pyeloplasties (16 cases), radical nephrectomies (2), simple nephrectomies (4), renal cyst decortication (5), ureterolithotomy (2) ureteral reimplantation (2) and partial ureterectomy (1)...
January 2016: World Journal of Urology
Manuel Planells Roig, Consuelo Arnal Bertomeu, Rafael Garcia Espinosa, Maria Cervera Delgado, Miguel Carrau Giner
OBJECTIVE: Difference analysis of ambulatorization rate, pain, analgesic requirements and daily activities recovery in patients undergoing laparoscopic cholecystectomy with standard multiport access (CLMP) versus a minilaparoscopic, 3mm size, technique. METHODS: Prospective randomized trial of 40 consecutive patients undergoing laparoscopic cholecystectomy. Comparison criteria included predictive ultrasound factors of difficult cholecystectomy, previous history of complicated biliary disease and demographics...
February 2016: Cirugía Española
Stefano Uccella, Antonella Cromi, Jvan Casarin, Giorgio Bogani, Maurizio Serati, Baldo Gisone, Ciro Pinelli, Maddalena Fasola, Fabio Ghezzi
OBJECTIVE: Hysterectomy for enlarged uteri is a surgical challenge. Our aim was to compare perioperative outcomes, cosmesis, and postoperative quality of life following laparoscopic hysterectomy for large uteri using minilaparoscopic 3-mm versus conventional laparoscopic 5-mm instruments. SUBJECTS AND METHODS: We prospectively enrolled women with a uterus between 16 and 20 weeks of gestation at the preoperative examination. These patients underwent laparoscopic procedures using either 3-mm (minilaparoscopy group) or 5-mm (standard laparoscopy group) instruments...
May 2015: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Valerio Gallotta, Camilla Nero, Vito Chiantera, Giovanni Scambia
STUDY OBJECTIVE: To show the feasibility of performing aortic lymphadenectomy with 3-mm instruments in gynecologic malignancies. PATIENT: A 43-year-old, multiparous patient with serous ovarian cancer grading 2, Fédération Internationale de Gynécologie et d'Obstétrique stage IC (intraoperative spillage). INTERVENTION: The patient was accidentally diagnosed with ovarian cancer after a right adnexectomy performed for an ovarian cyst. Once referred to our center, a delayed surgical staging was planned including total hysterectomy, left adnexectomy, aortic and pelvic lymphadenectomy, peritoneal biopsies, and total omentectomy...
May 2015: Journal of Minimally Invasive Gynecology
Ronald Daher, Elie Chouillard, Yves Panis
Single-incision laparoscopic surgery (SILS) and natural orifice transluminal endoscopic surgery (NOTES) have rapidly gained pace worldwide, potentially replacing conventional laparoscopic surgery (CLS) as the preferred colorectal surgery technique. Currently available data mainly consist of retrospective series analyzed in four meta-analyses. Despite conflicting results and lack of an objective comparison, SILS appears to offer cosmetic advantages over CLS. However, due to conflicting results and marked heterogeneity, present data fail to show significant differences in terms of operative time, postoperative morbidity profiles, port-site complications rates, oncological appropriateness, duration of hospitalization or cost when comparing SILS with conventional laparoscopy for colorectal procedures...
December 28, 2014: World Journal of Gastroenterology: WJG
H Gimbernat, C Redondo, A García-Tello, E Mateo, J M García-Mediero, J C Angulo
OBJECTIVE: To analyze the outcomes of umbilical laparoendoscopic single-site (LESS) ureteral reimplantation using a reusable single-port platform. MATERIAL AND METHOD: The casuistic of LESS ureteral reimplantation in 5 patients is presented. The surgical technique using KeyPort system (reusable umbilical single-site platform) is described. Dissection, suctioning and suturing by minilaparoscopy through 3.5mm accessory port in the iliac fossa are performed. Operative and postoperative outcomes are presented...
April 2015: Actas Urologicas Españolas
Ying Woo Ng, Li Min Lim, Yoke Fai Fong
Minilaparoscopy is an attractive approach for hysterectomy due to advantages such as reduced morbidities and enhanced cosmesis. However, it has not been popularized due to the lack of suitable instruments and high technical demand. We aim to highlight the first case of minilaparoscopic hysterectomy reported in Asia and the use of a new integrated energy platform, Thunderbeat. We would like to propose an alternative method of instrumentation, so as to improve the feasibility and safety of minilaparoscopic hysterectomy...
May 2014: Journal of Obstetrics and Gynaecology Research
M D Tyson, M R Humphreys
This article reviews the development of laparo-endoscopic single-site surgery (LESS), minilaparoscopy (MiniLap), and natural orifice transluminal endoscopic surgery (NOTES) with a particular focus on the applications in urologic surgery. We also provide the reader with a focused summary of the relevant nomenclature, history, and comparative outcomes. A literature search was conducted on LESS, MiniLap, needlescopy, microlaparoscopy and NOTES procedures in urology which is current through January 2013. The most relevant contemporary publications were selected and the pertinent findings were reviewed...
March 2014: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Francesco Porpiglia, Riccardo Autorino, Antonio Cicione, Vincenzo Pagliarulo, Mario Falsaperla, Alessandro Volpe, Ali Serdar Gozen, Antonio Celia, Marco De Sio, Alberto Saita, Rocco Damiano, Monica Zacchero, Cristian Fiori, Carlo Terrone, Riccardo Bertolo, Francesco Greco, Alberto Breda, Estevao Lima, Jens Rassweiler
OBJECTIVES: To provide an analytical overview of contemporary indications, techniques, and outcomes of urologic minilaparoscopy (ML) in multiple European centers. METHODS: Data of patients who had undergone a minilaparoscopic urologic procedure at nine European institutions between 2009 and 2012 were retrospectively gathered. Surgical procedures were classified as upper or lower urinary tract and as ablative or extirpative and reconstructive. The main surgical outcome parameters were analyzed and relevant operative data related to the surgical technique were recorded...
August 2014: Journal of Endourology
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