Minilaparoscopy is a new minimally invasive surgical technique that differs from the well known laparoscopic surgery due to the utilization of much smaller instruments, of 2 to 3 mm, instead of the conventional instruments, which are 5 or 10mm.
There has been a constant search for new access means in the laparoscopic surgery, trying to decrease the number and size of the surgical incisions to make the already know “surgery of the holes on the abdomen” a much more advanced technique. New equipment and means of access, such as the “Single Port” have appeared.
The surgical team of the IJP has always had a commitment to excellence and, within the so-called ‘new accesses’, we are one of the pioneer groups in Brazil in the utilization of the minilaparoscopy, because we believe that it is safer and more logical. By using some technical adaptations and special materials, the experienced surgeon can perform his art with general results equivalent to the conventional laparoscopic surgery with superior aesthetic results. Currently, the minilaparoscopic surgery can be used safely in selected patients, in the following surgeries:
- Cholecystectomy (surgery for “gall-bladder stones”)
The procedure is performed in the hospital, under general anesthesia, exactly as the conventional laparoscopic cholecystectomy. Internally, the differences are the need for a higher level of skill and training of the surgeon to tie the surgical knots instead of metal clips. The technical difference is due to the fact of the surgeon working with 3 portals of 2 or 3 mm, instead of portals of 10 and 5 mm., what results in smaller incisions that do not even need surgical stitches, resulting in a less aggressive surgery and superior aesthetic result.
- Surgery for hiatal hernia (anti-reflux surgery)
For selected cases, in the hospital, under general anesthesia, such as in the conventional laparoscopic fundoplication, the hernia orifice is closed and an anti-reflux valve is prepared. In the case of a minilaparoscopic surgery, the 10 and 5 mm portals are replaced by 2 or 3 mm portals and the optic by shifting the 45 degree optic preferably to the umbilical scar, the 10 mm portal scar is “hidden”, and an aestheticaly superior surgery is obtained.
- Surgery for inguinal hernias
In the TEP technique, without the use of staplers, under general anestesia, in the hospital, the surgeon replaces the 5 or 10mm portals (where the scars are) by 2 or 3 mm portals, performing the hernia correction, using meshes with the same safety of the conventional laparoscopic surgery. Some authors believe that in smaller surgical sites, such as the extra peritoneal space, the use of more delicate and smaller instruments produces excellent aesthetic results.
- Surgeries for excessive sweating (toraxic and lumbar sympatectomies)
Performed in the same manner as the conventional laparoscopic sympatectomies, with the same safety, including the fact that the surgeon works in restricted spaces such as the retroperitoneal with more freedom of movement with the instruments.The difference in the case of minilaparoscopic surgery is in the fact that the 5 or 10 mm portals are replaced by 2 or 3 mm portals, with excellent aesthetic results.
- Diagnostic laparoscopies, hepatic biopsies and gynecological laparoscopies
Can everyone be submitted to minilaparoscopy surgeries?
No. Currently, patients with morbid obesity or patients with voluminous livers (steatotic) and patients with multiple abdominal surgeries or who are not concerned with the aesthetic represent cases of relative if not absolute counter indication to the method. When the patient looks for safety in the surgical procedure and there is an aesthetic concern towards the scars, the minilaparoscopy certainly represents the safest and most logical alternative. The IJP surgeon team has large experience in all these surgeries, and is a pioneer in some of them nationally and globally.