Low-Friction Minilaparoscopy Outperforms Regular 5-mm and 3-mm Instruments for Precise Tasks.

Journal Article (Journal Article)

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. This study is an objective evaluation of a new set of mini instruments with a novel low-friction design. METHOD: Twenty-two medical students and 22 surgical residents served as study participants. Three designs of laparoscopic instruments were evaluated: conventional 5mm, traditional 3 mm, and low-friction 3 mm. The instruments were evaluated with a standard surgical simulator, emulating 4 exercises of various complexities, testing grasping, precise 2-handed movements, and suturing. The metric measured was time to task completion, with 5 replicates for every combination of instrument-exercise-participant. RESULTS: For all 4 tasks, the instrument design that performed the best was the same in both the medical student and surgical resident groups. For the gross-grasping task, the 5-mm conventional instruments performed best, followed by the low-friction mini instruments. For the 3 more complex and precise tasks, the low-friction mini instruments outperformed both of the other instrument designs. CONCLUSION: In standard surgical simulator exercises,low-friction minilaparoscopic instruments outperformed both conventional 3- and 5-mm laparoscopic instruments for precise tasks.

Full Text

Duke Authors

Cited Authors

  • Firme, WA; Carvalho, GL; Lima, DL; Lopes, VGDP; Montandon, ID; Santos Filho, F; Shadduck, PP

Published Date

  • July 2015

Published In

Volume / Issue

  • 19 / 3

PubMed ID

  • 26390530

Pubmed Central ID

  • PMC4558417

Electronic International Standard Serial Number (EISSN)

  • 1938-3797

Digital Object Identifier (DOI)

  • 10.4293/JSLS.2015.00067


  • eng

Conference Location

  • United States