Use of 3 mm percutaneous instruments with 5 mm end effectors during different laparoscopic procedures

Abstract

Background and purpose: With a recent focus on minimizing the visibility of scars, new techniques have been developed. Minilaparoscopy reemerged as an attractive option for surgery as it limits tissue trauma, reduces post-operative pain and improves cosmesis. This study was designed to describe our experience with percutaneous trocarless 3 mm instruments used in combination with standard 5 mm and 10 mm laparoscopic instruments in different general surgery procedures.

Methods: We used the PSS (Percutaneous Surgical Set, Ethicon Endo surgery, Cincinnati, OH, USA) in different surgical procedures as accessory instruments in combination with standard 5 mm and 10 mm standard laparoscopic instruments.

Main findings: The use of percutaneous instruments was safe and feasible in all performed procedures. The surgical technique was not modified. The percutaneous instruments can assure a good grip and can be used for traction and counter-traction. No complications have been described. No pain at the site of insertion has been reported. The skin, muscle and peritoneal defects were smaller than with the 3 mm laparoscopic traditional instruments.

Conclusions: Percutaneous approach seems to be a good option in general surgery in terms of efficiency, offering better cosmetic results and good pain control.

Keywords: Minimally invasive surgery; NOTES™; Percutaneous instruments; Single-port surgery.