Laparoscopy: advances in biopsy and recording techniques.

We have developed a second puncture accessory set and photographic technique for laparoscopy which are easy to use and potentially safer than others commonly used. A smaller second trocar (4mm) with various biopsy accessories, suction-coagulation cannula, and insulated grasper has been developed and successfully used in a series of more than 400 high risk patients where tissue samples were obtained under local anesthesia without serious complications or fatalities. The smaller size facilitated easy and safe introduction and manipulation. For laparoscopic photography a presterilized quartz rod attached to a sealed flash tube is used which is synchronized with a flash generator and 35-mm camera. An accessory trocar and the quartz rod are introduced under visual guidance parallel to the examining trocar. A separate "modeling" light is incorporated to provide illumination for observation. This photographic technique provides excellent illumination through a smaller trocar and probe than previously reported.