The microlaparoscope should be used routinely for diagnostic laparoscopy.

OBJECTIVE

To describe the experience of changing from the use of the 10-mm standard laparoscope to the use of the 2-mm microlaparoscope (MicroLap, Imagyn Medical Inc., Laguna Niguel, CA) and to compare the amount of postoperative pain and requirement for analgesics after each technique.

DESIGN

Prospective study.

SETTING

Day surgery unit in an academic reproductive medicine unit.

PATIENT(S): One hundred thirty-five women undergoing diagnostic microlaparoscopy.

INTERVENTION(S): Diagnostic laparoscopy with a 2-mm instrument. Recording of postoperative pain on an analog scale.

MAIN OUTCOME MEASURE(S): Ability to complete the procedure satisfactorily with the microlaparoscope, pain scores, and use of analgesics.

RESULT(S): All diagnostic procedures were performed satisfactorily with the use of the MicroLap. Patients who underwent MicroLap procedures had significantly less abdominal pain postoperatively, but there was no difference in shoulder tip (gas-related) pain. Less analgesia was required after the microlaparoscopy.

CONCLUSION(S): In most situations, the microlaparoscope is the instrument of choice for initial diagnostic laparoscopy. The 10-mm laparoscope should be used only as a secondary instrument after microlaparoscopy, if indicated.