There are three types of laparoscopes
- 6-18 rod lens systems
- 0, 30, 45 & 120 degree laparoscopes
- 1.5 to 15mm laparoscopes
Our recommendation would be to ONLY use the Johns Hopkins Forward Oblique 300 laparoscope (10mm diameter, 33cm length) for colorectal and advanced laparoscopic surgery; a 00 is insufficient (ok for prostatectomy). Check that it is autoclavable - if not it will break. Change it/trade it in with Storz. Most companies produce extra long 46cm scopes for use in morbid obesity patients.
At the distal end is a front lens complex IRLIS (inverted real image lens system) which creates an inverted, real image. A number of IRLIS transport the image to the eyepiece and magnifying lens. In the Hopkins system, light is transmitted through glass columns and refracted through intervening air lenses.
The 30 degree forward oblique scope permits the surgeon far greater latitude for viewing underlying areas, often under difficult conditions. Be warned, it does take some time getting used to interpreting the image that they produce. They are however, incredibly efficient and invaluable. They almost allow you to see around corners.
They are essential in TEP inguinal hernia repairs, CBD exploration and any surgery carried out in the retroperitoneum. We would suggest that you use them in all cases. If someone tells you otherwise they either have not done enough, or they haven't mastered the 30 degree image. Remember it takes time learning how to use them optimally. As with all things in life practice makes perfect.
Karl Storz HopkinsII laparoscope – 30 forward oblique
Product No. 26003BA
These have stood the test of time (Hopkins invented them in 1951). Whilst Karl Storz has a reputation for being expensive, the image is bright, even, crisp and clear. Storz also offer a 50% discount part exchange on any old scope that you present to them (worth a tidy sum) and their warranty is for two years.
Contact details: Karl Storz Endoscopy (UK) Ltd, 392 Edinburgh Avenue, Slough, Berkshire, SL1 4UF. Tel., 0175 503500 or firstname.lastname@example.org
Smith & Nephew 30 forward oblique laparoscope (7208129)
Smith & Nephew make cheaper scopes (approaching 50% of the Storz price) with a one year warranty. Their biggest selling point, apart from price has been their 24hr after sales service and in-house training packages.
Contact details: Smith & Nephew Endoscopy, Endoscopy House, Cardinal Park, Godmanchester, Huntingdon, PE 29 2SN. Tel: 01480 423 200.
Olympus KeyMed 30 laparoscope (A5295A)
KeyMed Olympus has a full range including:10mm High Definition Laparoscopes that are autoclavable. KeyMed offer a one year unconditional guarantee and a five year autoclavable guarantee. 10mm operating (we never use these), 5.4mm full screen and 3mm laparoscopes are also available to suit personal preference and clinical application.
If you have lots of money available go for the HD EndoEYE (10mm, 39cm) - a fully integrated HDTV video laparoscope. This new range achieves near picture-perfect imaging performance with almost four times the resolution of traditional laparoscopes. The image is both focus and distortion free, ensuring a consistently clear view. These are all factors that increase the accuracy of surgery and make it much easier for the surgeon to concentrate. The surgeon is also less likely to get a head ache.
This is a very impressive system and if we could afford it we would always use it. The pictures are so clear and bright you alsmost need a pair of shades! The optics certainly compensate for any slight deficiencies of your eye sight! Once you have used it you will never want to go back to your old system. It is fantastic!
The autoclavable guarantee is 5 years; their unconditional guarantee is one year.
For this sytem to work you need to purchase the camera (£ 7,500 plus VAT), light lead (£ 475), light source and monitor (£12,000). HD telescopes are optional (approx £3,000); 25% discount if an old scope is exchanged.
Bristol Laparoscopic Associates strongly recommend pairing this up with the Olympus insuflator with facility for extracting the vapour plume. Although this costs around £ 6,500 it is money well spent and avoids hours of frustration.
For approx £11,500 you get the optional integrated video laparoscope "endoeye". It is certainly worth it for complex cases. If you buy a second you get a 50% discount.
Quite an investment - but in Bristol Laparoscopic Associates view, well worth it. Their DVD recorder (£ 2,400 plus VAT) is very impressive also.
KeyMed are keen for people to trial this system. Give them a call or use our link.
KeyMed (Medical & Industrial
Essex SS2 5QH
Brilliant high-definition image. Sizes include: 2.7mm diameter scope available in 0, 30, and 70 degree; 5mm and 10mm diameter with 0, 30 and 45 degree
Stryker UK Limited
RG14 5EG UK
Phone :+44 (0) 1635 262400
Fax :+44 (0) 1635 580300
Richard Wolf Laparoscopes
Like the others, Wolf laparoscopes produce clear images and are both durable and autoclavble.
Contact address:Richard Wolf UK Ltd Waterside Way Wimbledon, London SW17 0HB, UK. Tel: 020 8944 7447 Fax: 020 8944 1311
Remember, for best results keep the laparoscope warm – electrical warmers are OK but scopes quickly cool off in the abdomen. If you do not enjoy the luxury of an automatic ploom extraction system, hot water in a sterile thermos flask is ideal and easy solution e.g. Applied Medicals flask part No. C3001/C3002/C3101.
Contact details; Mantis Surgical, Ltd. Adam Power, Unitech House, Units B1 & B2, Kingsland Business Park, Basingstoke, Hamshire,RG24 8P2. Tel., 01256 365450. sward@MantisSurgical.ltd.uk