Authors: O. Sizzi, A. Rossetti

Minilaparoscopy surgery usually uses 3 or 2 mm instruments.
The benefits of this kind of technique and instruments is the exploiting at maximum the advantages of minimal invasive surgery.
The disadvantage is that the instruments usually have thin and fragile forceps.

The Japanese company “HIRATA PRECISION” built new instruments with a 2 mm insert and 5 mm forceps tip. These instruments are introduced through the skin using a shaft with an inner needle that is then passed through the optic trocar. The inner needle is removed and the instrument is introduced and pushed out from the skin. The handle is then inserted.

The shaft, after the removal of the inner needle can be used like suction-irrigation cannula. The main advantage of these instruments is to achieve a tight and trustworthy grasping with the 5 mm forceps while the incision on the skin is only 2 mm in diameter. Obviously it will not be possible to change the position of the instruments during the procedure.
These instruments can be used like an additional operative port during some very complex procedures or can be used together with a 3 mm trocar and 3 mm instruments to perform a hybrid minilaparoscopy.

We used these instruments both for hybrid minilaparoscopies for some procedures on the adnexa (Salpingectomies, Adnexectomies, Ovarian Cysts, Salpingoplasties) and like fourth operative port during more complex procedures like adesiolysis for frozen pelvis or endometriosis or uretal reimplantation.