Microlaparoscopic Instrumentation for Operative Laparoscopy


OBGYN.net Conference CoverageFrom Society of Laparoscopic SurgeonsNew York, December, 1999

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Dr. Larry Demco: "Dr. Seckin works here in New York, and I've been a promoter of microlaparoscopy myself for many years, but this has been mainly in the diagnostic modalities of microlaparoscopy. Do you find that there's a role for the use of microlaparoscopic instruments in operative laparoscopy?"

Dr. Tamer Seckin: "My answer is absolutely, yes. A microlaparoscopy approach should be the preferred entrance to the abdominal cavity. It's the first way and the first step to decrease complications of trocar injuries and to prevent complications of Veress needle injuries. Apart from that, it is a great way of diagnosing pathologies. If the surgeon feels comfortable to go along with the macrolaparoscopy with bigger trocars and so-called 'better vision' scopes, he's welcome to do so. Yet it's a great way to access every little corner of the abdominal cavity, rather than using regular laparoscopy approaches. Today it's possible to do even hysterectomies with microlaparoscopy. It's the surgeon that counts, not the instruments."

Dr. Larry Demco: "What in the development of microlaparoscopic instruments has changed the way we do things, such that you're saying we can now use these microlaparoscopic instruments? What has changed in them that made you change?"

Dr. Tamer Seckin: "That's a very good question. I think the resolution of the optics have come to the stage that you can get almost as close visualization of the pelvic cavity and peritoneum right now as with the present instruments. It is more durable; they don't break as much as they used to break, like the glass rods we used in the past. On top of that, we do have suturing techniques that we could utilize from ancillary reports with microlaparoscopy. In other words, we do have other instruments that are developed along similar lines that we use in macrolaparoscopy cases."

Dr. Larry Demco: "The patient is the ultimate consumer. How do see microlaparoscopy as an advantage to the patient?"

Dr. Tamer Seckin: "I think the advantages are tremendous. One of the bigger advantages is absolutely no scarring or stitching. To start with, that means the same incision that we use for macrolaparoscopy will have almost no complications at all. We see hernias, even eviscerations through 1-cm scars, infected badly, healed scars, and pain - these are absolutely no occasions for microlaparoscopy cases."

Dr. Larry Demco: "So you say that the ability to have a much smaller scar cosmetically, as well as reporting no complications of healing, such as hernias, are more improved for the patient. I think that the patients themselves are more cosmetically minded. And they are especially looking at microlaparoscopy as a way of not only doing things better, but from the patient's point of view, from what she sees, which is the incision itself. I'd like to thank you very much for your time."

Dr. Tamer Seckin: "Thank you."

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