8 - Microlaparoscopy

Summary

INTRODUCTION

The history of endoscopies goes back to 1805 when Bozzani managed to visualize the urethra using a very primitive tool known as Lichtleiter that depended on a candle as a light source (1).

It was not until 1910, when the term laparoscopy was designated by Jacobaeus (2), who reported the first human laparoscopy using a Nitze cystoscope (3) to visualize different body cavities, although he did not employ pneumoperitoneum at that time. Fevers (4) was the first to report operative laparoscopy in 1933, when he performed the lysis of some adhesions and obtained a number of biopsies.

In the 1940s, extensive laparoscopic research was done by Palmer (5) who advocated the use of Trendelenburg position for improved visualization during laparoscopy and later was the first to report human oocyte retrieval in 1961 (6).

Further technological advancements in the field of fiber optics along with the introduction of automatic CO₂ insufflators in the 1970s dramatically improved laparoscopic procedures (7).

The introduction of laparoscopy in the field of gynecology was a historic landmark as it gradually replaced the traditional laparotomy. Currently, most of the gynecologic surgeries are performed laparoscopically, which undoubtedly decreased the rate of morbidity and complications along with hastening the patient recovery.

In order to decrease the surgical trauma during endoscopic procedures, miniatures of traditional laparoscopies utilizing instruments 2–5 mm in diameter were developed (8, 9) and were known as minilaparoscopy or microlaparoscopy.