Why don't more doctors do endoscopic tummy tucks?

Endoscopic procedures use a combinations of very small incisions and long instruments with a camera.  We have several procedures that can be done endoscopically, but unfortunately, tumm tuck is not one of them. This approach can tighten the muscles but cannot remove loose skin.  ANy laser or Radiofrequency device might tighten the skin a little, but not enough to make a tummy tuck unnecessary.  In this situation, stick with the tried and true procedure 0 standard abdominoplasty.

Perhaps for diastasis alone, but otherwise the endoscope has not been useful for tummy tuck, and no laser heating or other treatments will shrink the abdominal skin.
Best of luck,
peterejohnsonmd

Endoscopic surgery is a real advance in many areas of plastic surgery.  However, when there is extra skin and fat to be removed, as in a typical tummy tuck, then endoscopy has NO role to play.  There are almost no cases in my over 25 year experience that would have benefitted from this type of operation.  I have seen perhaps one patient who only had muscle weakness following delivery, who did not have any extra skin to get rid of.

So called  "Heat therapy" can only minimally tighten tissues.  I have invested hundreds of thousands of dollars in these technologies over the years, so I know what I am talking about.  The results of non operative heat therapy are very very modest, and they have very very limited use.  A patient with loose excess tummy skin will almost always benefit from a full tummy tuck.  It is a very satisfying operation with extremely high approval ratings.

The answer is if the results were acceptable we would do endo TT's. But poor results cause a bad idea for an operation to be unacceptable. A "STANDARD of CARE" issue. From MIAMI 

The endoscopic abdominoplasty is indicated for patients who have no loose skin, minimal excess fat of the lower abdomen and bulging of the abdominal wall. The endo TT as a small incision in the pubic region that allows for no skin excision. As most patients seeking TT have some skin laxity to deal with, the endoscopic procedure is the least commonly perfomed.  In our own practice we have performed 5 different types of abdominoplasties based on patients wishes: endoscopic, reverse, midline, mini, and standard. Please see our website to see what would be best for you. 

Endoscopic tummy tucks are not performed because of the need to excise excess skin.  The heat therapy to which you alluded is really not effacious for this amount of excess skin and is used primarily by nonsurgeons.  I agree that an endoscopic tummy tuck could be done if the only problem is diastasis recti; however, this would be a very uncommon situation.