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Update on laparoscopic surgery: surgeon's point of view

New instruments have been developed, with miniaturization (3 mm trocars and forceps). The optical systems also improved, with better visualization, in spite of the small size. Minimally invasive surgery is actually ‘very minimally invasive surgery’ (VMIS). These changes have allowed the development of laparoscopic surgery in newborns (1,2). In older children, tissue trauma is minimal, with excellent esthetic results. Coagulating systems, such as the harmonic scalpel, allow the control of vessels and parenchymal dissection (partial splenectomy or nephrectomy) with complete security. New techniques and indications