New trends in minimally invasive urological surgery

Laparoscopic colorectal resections have been shown to provide short-term advantages in terms of postoperative pain, general morbidity, recovery, and quality of life. To date, long-term results have been proved to be comparable to open surgery irrefutably only for colon cancer. Recently, new trends keep arising in the direction of minimal invasiveness to reduce surgical trauma after colorectal surgery in order to improve morbidity and cosmetic results. The few reports available in the literature on single-port technique show promising results. Natural orifices endoscopic techniques still have very limited application. We focused our efforts in standardising a minilaparoscopic technique (using 3 to 5 mm instruments) for colorectal resections since it can provide excellent cosmetic results without changing the laparoscopic approach significantly. Thus, there is no need for a new learning curve as minilaparoscopy maintains the principle of instrument triangulation. This determines an undoubted advantage in terms of feasibility and reproducibility of the procedure without increasing operative time. Some preliminary experiences confirm that minilaparoscopic colorectal surgery provides acceptable results, comparable to those reported for laparoscopic surgery with regard to operative time, morbidity, and hospital stay. Randomized controlled studies should be conducted to confirm these early encouraging results.

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“…Manipulation of tiny laparoscopic instruments may result in an increased risk of tissue damage during dissection [16, 74, 76–79]. …”

Section: Discussionmentioning

confidence: 99%

Minilaparoscopic Colorectal Resections: Technical Note

Bona

Molteni

Montorsi

2012

Minimally Invasive Surgery

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“…With the currently available technology, needlescopic instruments have two restrictions related with surgical optics and manipulability. A needlescope is hampered by poor illumination, resolution, and clarity because of limitations with the optics of the rod-lens, and tiny laparoscopic instruments are not as sturdy and manipulable as larger instruments; furthermore, it is necessary to consider the increased risk of tissue damage during dissection using the pointed ends of fine graspers [14,15]. These problems could potentially prolong the operation time, increase the risk of perioperative complications, or impose stress on surgeons.…”

Section: Discussionmentioning

confidence: 99%

Reevaluation of needlescopic surgery

Tagaya

Kubota

2011

Surg Endosc

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“…Technological advancements made possible to further miniaturize laparoscopic instruments to <2 mm introducing microlaparoscopy as a new field in minimally invasive approaches to surgery, with promising results in the diagnostic evaluation of the pelvis already reported [21][22][23]. In addition, novel minirobotic instruments are under development and are expected to combine the reductive invasiveness of minilaparoscopy with the well-documented benefits of robotic assistance in the future [24].…”

Section: Discussionmentioning

confidence: 99%