Randomized comparative study of conventional minilaparoscopy (5mm) versus modern minilaparoscopy (2.9mm) in patients of infertility

Authors

  • Kallol Kumar Roy Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.
  • Nandini Joshi nee Jahagirdar Department of Obstetrics and Gynaecology, Kamineni Academy of Medical Sciences and Research Center, Hyderabad, Telangana, India
  • Murali Subbaiah Department of Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Tamil Nadu, India.
  • Sunesh Kumar Jain Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.
  • J. B. Sharma Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.
  • Neeta Singh Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20171424

Keywords:

Conventional minilaparoscope, Direct trocar entry, Modern minilaparoscope, Mean hospital stay

Abstract

Background: To compare diagnostic conventional minilaparoscopy (5mm) with diagnostic modern minilaparoscopy (2.9mm) in patients of infertility in terms of operating time, post-operative pain, hospital stay.

Methods: A prospective randomized comparative study was done in a tertiary care centre involving eighty patients of infertility undergoing diagnostic laparoscopy. Diagnostic laparoscopy was done using 5mm laparoscope (Conventional minilaparoscope-Group I) in 40 patients and using 2.9mm laparoscope (Modern minilaparoscope-Group II) in 40 patients. Operating time was measured from the point of skin incision to closure, post op pain was assessed with VAS scoring system, total hours of hospital stay from shifting to day care recovery ward till discharge was noted.

Results: Both conventional minilaroscope and modern minilaparoscopes were comparable to each other. Operating time in both groups was similar (7.7min in Group I vs 8.7min in Group II). In both groups, there was no statistically significant difference in post-operative pain as assessed by VAS scoring System (39 in Group I vs 38 in Group II had mild post-op pain and 1 in Group I vs 2 in Group II had moderate pain). The difference in duration of post-op hospital stay in both Group I and group II was not statistically significant (3.5 hours vs 3.3 hours).

Conclusions: Both conventional minilaparoscopy (5mm laparoscope) and modern miniaparoscopy (2.9mm laparoscope) are comparable with respect operating time, post-op pain, hospital stay. Modern minilaparoscope is no better than conventional minilaparoscope.

References

Jan Bosteels, Bruno Van Herendael, Steven Weyers, Thomas D’Hooghe. The position of diagnostic laparoscopy in current fertility practice. Human Reprod Update. 2007;13(5):477-85.

Fear RE. Laparoscopy: a valuable aid in gynecologic diagnosis. Obstet Gynecol. 1968;31:297-309.

Montz FJ, Holschneider CH, Munro MG. Incisional hernia following laparoscopy: a survey of the American Association of Gynecologic Laparoscopists. Obstet Gynecol. 1994;84:881-4.

Rabinnerson D, Avrech O, Neri A. Incisional hernias after laparoscopy. Obstet Gynecol Surv. 1997;52:701-3.

O'Donovan PJ, McGurgan P. Microlaparoscopy. Surgical Innovation. 1999;6(2):51-7.

Dávila ÁF, Montero PJJ, Dávila ÁU, Dávila ZMR, Lemus AJ, Sandoval RJ. Unify criteria proposed for the minilaparoscopy surgery classification. Rev Mex Cir Endoscop. 2004;5(2):90-8.

Dorsey, J.M. and Tabb, C.R. Mini-laparoscopy and fiber optic lasers. Obstet. Gynecol. Clin. North Am.1991;18:613-7.

Risquez F, Pennehouat G, Foulot H, Mathieson J, Dubuisson JB, Bonnin A, et al. Transcervical tubal cannulation and Falloposcopy for the management of tubal pregnancy. Hum. Reprod. 1992;7:375-6.

Bauer O, Devroey P, Wisanto A, Gerling W, Kaisi M, Diedrich K. Small diameter laparoscopy using a microlaparoscope. Human Reproduc. 1995;10(6):1461-4.

Molloy D: The diagnostic accuracy of a microlaparoscope. J Am Assoc Gynecol Laparosc. 1995;2:203-6.

Haeusler G, Lehner R, Hanzal .Diagnostic accuracy of 2 mm laparoscopy. Acta Obstet Gynecol Scand. 1996;75:672-5.

Faber BM, Coddington CC. Microlaparoscopy: a comparative study of diagnostic accuracy. Fertil Steril. 1997;67:952.

Fuller PN. Microendoscopic surgery: A comparison of four microendoscopes and a review of the literature. Am J Obstet Gynecol. 1974:1757-62.

Karabacak O, Tiras MB, Taner MZ, Guner H, Yildiz A, Yildirim M. Small diameter versus conventional laparoscopy: a prospective, self-controlled study. Human reproduction. 1997;12(11):2399-401.

Zullo F, Pellicano M, Zupi E, Guida M, Mastrantonio P, Nappi C. Minilaparoscopic ovarian drilling under local anesthesia in patients with polycystic ovary syndrome. Fertil Steril. 2000;74(2):376-9.

Pellicano M, Zullo F, Fiorentino A, Tommaselli GA, Palomba S, Nappi C. Conscious sedation versus general anaesthesia for minilaparoscopic gamete intra-Fallopian transfer: a prospective randomized study. Hum Reprod. 2001;16(11):2295-7.

Kovacs GT, Baker G, Dillon M, Peters M. The microlaparoscope should be used routinely for diagnostic laparoscopy. Fertility and sterility. 1998;70(4):698-701.

Pellicano M, Zullo F, Di Carlo C, Zupi E, Nappi C. Postoperative pain control after microlaparoscopy in patients with infertility: a prospective randomized study. Fertil Sterril.1998;70(2):289-92.

E Zupi, D Marconi, M Sbracia, E Solima, F Zullo, M Dauri et al. Is local anesthesia an affordable alternative to general anesthesia for minilaparoscopy? J Am Assoc Gynecol Laparosc. 2000;7(1):111-4.

Ikeda F, Abrão MS, Podgaec S, Nogueira AP, Neme RM, Pinotti JA. Microlaparoscopy in Gynecology: analysis of 16 cases and review of literature. Rev. Hosp. Clín Fac Med S. Paulo. 2001;56(4):115-8.

Downloads

Published

2017-03-30

Issue

Section

Original Research Articles