4. Advantages/disadvantagesAngle of view:
Most laparoscopic surgical procedures can be performed with straight (0 degree) endoscopes. Some surgeons, however, prefer to use endoscopes with an angled line of sight, usually 30 degrees, in order to explore areas that are difficult to visualize (gastroesophageal reflux disease surgery, urological surgery, gynecological surgery).
Advantages of forward looking endoscope (0 degree):
- most common type of scope => wide choice;
- effective for most procedures;
- higher brightness;
- larger field of view;
- larger depth of field.
- but unable to visualize some operative areas.
Advantages of 30 degree, 50 degree, 70 degree endoscopes:
- possibility to explore areas of the operative field that are difficult to access with a 0° endoscope.
- lower brightness;
- more difficult to control field of view;
- light post must be kept vertical to avoid rotating field of view.
Gauge of endoscope:
The wider the endoscope the more light transmitted and thus the better the final clarity of the viewed image. Narrower endoscopes have the advantage of passing down smaller trocars but generally have a narrower field of view. Thus a narrow scope may be perfectly adequate for a diagnostic or simple procedure and results in a smaller scar. However, for more complex procedures a broader scope gives a brighter and larger field of view.
An ideal endoscopic surgery kit would include a complete range of endoscopes (0 to 25, 30, 40, 50 and 70 degrees) and a variety of gauges (12, 10, 5 and even 3 mm). At the present time, since cameras are not sterilized, it is difficult to change endoscopes during the operation while maintaining proper sterilization. Before starting the operation, the surgeon usually has to choose the endoscope that will be used throughout the procedure.