Mini-laparoscopy and Percutaneous Surgery
In “standard” laparoscopy, the smallest port is a “5mm port”.
This is a bit misleading, as what this means is that the port will accept an instrument which is up to 5mm in diameter. The port obviously has to be bigger than that, and the outer diameter of a 5mm port can be up to 9.35mm! Similarly, a 12mm port takes a 12mm diameter instrument, and may be more like 15mm in outer diameter. The bigger the port, the more pain!
Mini-laparoscopic instruments are literally tinier versions of standard instruments. The outer diameter of the Karl Storz mini-laparoscopic instruments is 3.5mm. Dr Gan uses these for many of his gallbladder and some of his hernia operations.
Percutaneous instruments are typically tiny graspers which are used to grab and move internal organs and are inserted through a tiny skin incision without using a port. These include Teleflex’s MiniLap and Percuvance instruments. Dr Gan was the first surgeon in Australia to use the Percuvance instruments (not presently available – awaiting re-launch).