No Scalpel, No IV, No Stitch, Microendoscopic Office Laparoscopy Under Local Anesthesia

BACKGROUND: The medical literature is replete with articles verifying the usefulness of laparoscopic procedures under local anesthesia. Recent research has examined the efficacy of microendoscopy with local anesthesia. In this series of patients, we focused on new technology to determine if microendoscopy could be utilized in an office setting. METHODS: Between July 1994 and April 1995, we performed 51 microendoscopic office laparoscopy under local anesthesia (MICRO-OLULA) using the 1.5 mm Pixie laparoscope by Origin, a 1.7 mm laparoscope by Optimed and 5 mm laparoscope by Jarit. All cases were performed in an office operating room at the Women's Medical Plaza in Montgomery, Alabama. Only one patient was unable to have the procedure completed due to intolerance under local anesthesia. RESULTS: Fifty-one micro-olulas were performed on these patients who had an average age of 31 years and an average weight of 157 pounds. Intraoperative abdominal time averaged 3 minutes. One case was done with a 5 mm laparoscope and five cases with the 1.7 mm Optimed laparoscope. The 1.5 mm Pixie laparoscope was used in 45 patients. CONCLUSIONS: Our patients seemed to like the idea of a small device to view their pelvic cavities. The small laparoscopes provide excellent cosmesis, and laparoscopes deserve further development and clinical trial to determine their most advantageous use in the office setting.