Randomized comparative study of conventional minilaparoscopy (5mm) versus modern minilaparoscopy (2.9mm) in patients of infertility

Abstract

Background: To compare diagnostic conventional minilaparoscopy (5mm) with diagnostic modern minilaparoscopy (2.9mm) in patients of infertility in terms of operating time, post-operative pain, hospital stay.Methods: A prospective randomized comparative study was done in a tertiary care centre involving eighty patients of infertility undergoing diagnostic laparoscopy. Diagnostic laparoscopy was done using 5mm laparoscope (Conventional minilaparoscope-Group I) in 40 patients and using 2.9mm laparoscope (Modern minilaparoscope-Group II) in 40 patients. Operating time was measured from the point of skin incision to closure, post op pain was assessed with VAS scoring system, total hours of hospital stay from shifting to day care recovery ward till discharge was noted.Results: Both conventional minilaroscope and modern minilaparoscopes were comparable to each other. Operating time in both groups was similar (7.7min in Group I vs 8.7min in Group II). In both groups, there was no statistically significant difference in post-operative pain as assessed by VAS scoring System (39 in Group I vs 38 in Group II had mild post-op pain and 1 in Group I vs 2 in Group II had moderate pain). The difference in duration of post-op hospital stay in both Group I and group II was not statistically significant (3.5 hours vs 3.3 hours).Conclusions: Both conventional minilaparoscopy (5mm laparoscope) and modern miniaparoscopy (2.9mm laparoscope) are comparable with respect operating time, post-op pain, hospital stay. Modern minilaparoscope is no better than conventional minilaparoscope.

Feasibility and efficacy of modern minilaparoscopy with 2.9 mm laparoscope for diagnostic and level II gynaecological procedure

“…A small optical diameter leads to reduced light intensity; hence, the tip of the minilaparoscope should be placed closely to the viscera for a more precise visualization [2]. In a study by Roy et al [12], the size and quality of images projected on the screen were satisfactory during diagnostic laparoscopy with a 5-mm and 2.9-mm laparoscope.…”

“…Haeusler et al [ 17 ] performed a study including 52 patients who underwent laparoscopy with a 20-mm microlaparoscope and a 10-mm conventional laparoscope in the same session and found that the diagnostic accuracy of microlaparoscopy was comparable. Roy et al [ 12 ] found that 2.9-mm modern minilaparoscopy was effective in diagnosing infertility, chronic pelvic pain, and endometriosis. In our study, modern minilaparoscopy was found to be efficacious as a diagnostic technique in 99% of cases.…”

“…An earlier pilot study by Roy et al [ 12 ] had shown that the operating time was 8.7 minutes, with a standard deviation of 1.5, presuming the width of 95% confidence interval is 0.6 minutes. The adequate number of patients required to meet statistical significance at a 5% level of significance was 100.…”

“…It has been reported that minilaparoscopy is mainly performed using a 5-mm laparoscope with ancillary ports of 3 mm or smaller [9,10]. Very few studies have been performed with laparoscopes less than 5 mm [11][12][13]. However, conventional laparoscopy is commonly used in India, even for diagnostic purposes.…”

“…There is a lack of literature from India regarding minilaparoscopy, per our literature review. In a previous study by Roy et al [ 12 ], they performed a randomized comparative study on conventional minilaparoscopy (5 mm) and modern minilaparoscopy (2.9 mm) and found them comparable with respect to operating time, postoperative pain, and hospital stay. With this idea from the previous study, the present study included a comparatively larger number of patients to determine the feasibility of minilaparoscopy for operative intervention.…”