Same popular procedure performed with smaller tools

Tiny Technology–Big Change

April 1, 2018

Sometimes the smallest changes can make the biggest difference. That’s the case with the new approach Dr. Andrew Wu and the general surgeons at CMC’s Surgical Care Group are taking to laparoscopic surgery. “Mini-lap” is laparoscopic surgery using pediatric-sized instruments.

“There are two major benefits,” says Dr. Wu, who specializes in minimally invasive general and bariatric surgery at CMC. “There’s less scarring from the smaller incisions and the patients who’ve had this done say that they’ve had less pain around the incision sites.”

Popularized in the 1990s, traditional laparoscopic surgery involves three to five incisions—usually one to fit a 10-12 millimeter (mm) camera through, and others, usually5-10mm each for the instruments. Single incision surgery became popular starting in 2007. While this technique was cosmetically better with less scarring, it’s recently been associated with increased hernia rates. This is one reason why, around 2013, more surgeons began experimenting with the use of pediatric instruments in adult laparoscopic surgery. The tools at that time were functional, but not strong enough in most cases to handle heavier and thicker adult organs.

“But in the last two years, we’ve seen a new wave of instruments that are better built, more durable, and easier to use,” says Dr. Wu. 

Incisions in a mini-lap procedure are only 3mm wide and are glued, instead of stitched, closed. In less than a year, Dr. Wu has performed more than 20 mini-laps for gastric sleeve, gall bladder, and abdominal and groin hernia surgeries. 

The mini-lap isn’t for everyone, but can be ideal for certain patients, especially women in their 20s and 30s. “For the right patient,” says Dr. Wu, “it does make a difference.”