Instrumentation is a vital part of endoscopic surgery

Both hysteroscopy and laparoscopy are in need of specific instruments for specific uses


In hysteroscopy the great breakthrough has been the technical ability to reduce the outer diameters of the scopes and still remain with the same 5 French working channel.
This has enabled us to perform operations on an out-patient basis and without anaesthesia. One of the break throughs is the possibility to use electricity in its  bipolar form due to the design of the probes. Some bipolar reusable probes do exist. The bipolar application of electricity allows the use of ionic solutions, such as normal saline, potentially less harmful as compared to the non-ionic solutions ( type Glycine 1% ).
In Laparoscopy the mean story is the come back of the reusable instruments. A decade ago the work was mono-use. The reasoning was that a single use instrument was the top of the evolution of that instrument and that each generation of the instrument had to be better than its predecessor. Rightly so but we did not calculate the costs of these evolutions. Soon it became clear that if we would like to bring endoscopy to all our patients even the less better off we had to restart our thinking process and try to design instruments that are very performing and can stay so for a few years. At the ETCA some of the instruments are used for over 5 years before replacement.  Think about it. Our fathers did use one set of instruments during their whole medical career. It is not so much the instrument but the surgeon behind it that makes the difference. The bad craftsmen blame their tools.
Another inovation is the redesigning of the classical bipolar instrumentation so that the jaws can grasp tissues and coagulate. Bipolar scissors coagulate and in doing so cut the tissues. Some experience is needed to use these instruments with success. The novice will often have the impression that these instruments do not work properly whilst it is of importance to know that the jaws have to be some mm apart to let the current go from one electrode to the other. So the jaws of the scissors are not closed as the classical scissors and the jaws of the holding forceps have to be some mm apart to do the job well.
At the ETCA all the newest instruments from K.STORZ GmbH & Co are used and shown.


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ZNA STER Site Stuivenberg
Department Gynaecological Surgery
Department General Surgery

Lange Beeldekensstraat, 267
B-2060 Antwerp - Belgium
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