What is Microlaparoscopy?
Mark Perloe, M.D.
Microlaparoscopy is the newest minimally invasive surgical technique that revolutionizes diagnostic laparoscopy. Just as rapid advances in electronics have shrunk computers to a fraction of their original size, similar advances in surgical instrumentation offer new opportunities to diagnose and treat surgical disease.
While a standard laparoscope is about 10-12mm in size, (slightly less than 1/2 inch) recently developed microlaparoscopes are less than 3mm (slightly more than 1/10th of an inch). While previously small incisions were made inside the belly-button, now, certain surgical procedures can be performed with only a needle stick. I can place small scissors, graspers, biopsy instruments or a laser fiber through one or two additional 3mm needles. This enables me to perform diagnostic laparoscopy or simple surgical procedures using a local anesthetic and sedation through an intravenous catheter. This means much less incisional pain after your surgery. It also means less anesthetic, no sore throat, and less nausea. In many cases you may be able to resume all normal activities in just a few hours.
Frequently, laparoscopy is used to insure that the fallopian tubes are normal and there are no factors contributing to infertility. Unfortunately, sometimes I will find a problem that cannot be corrected with microlaparoscopy. If you have significant adhesions, endometriosis or other abnormalities, you will receive a general anesthetic and the operation is completed using standard laparoscopic techniques.
Pain mapping is another useful microlaparoscopic technique. If you are suffering from chronic pain and previous surgical procedures have not localized the cause, a microlaparoscopic procedure may provide the answer. A microlaparoscopic diagnostic procedure is performed while you are sedated, but still awake. I will use a probe to gently touch various structures such as the uterosacral ligaments, the ovaries, tubes, uterus, bladder or an adhesion to see if that area duplicates your pain. If the source of your pain is located, surgery may be more effective at providing relief.
Microlaparoscopy is in its infancy. Its' primary uses are for diagnostic surgery. But, as new instruments become available our capabilities will increase. I am very excited to offer my patients microlaparoscopy and truly believe this technique will simplify and reduce the cost of diagnosing the cause of pelvic pain and infertility.
Watch a 2 minute quicktime video demonstrating microlaparoscopic lysis of adhesions. (Caution, this file is10.2 megs. Your download times may be excessive if you do not have ISDN or T1access.)