TECHNICAL ASPECTS OF MINIMALLY INVASIVE ABDOMINAL-SURGERY PERFORMED WITH NEEDLESCOPIC INSTRUMENTS

Interest has grown in reducing the size of laparoscopic instruments. W e define as ''needlescopic'' those instruments that have a diameter of less than or equal to 3 mm. We compared data from 60 needlescopic cho lecystectomies with a matched group of laparoscopic procedures. No int raoperative complications occurred in either group. Operative time was 20% longer for the needlescopic operations. Hospital stay was similar for both groups. Postoperative analgesia requirements for the needles copic group were 70% lower than for the laparoscopic group. From a sca le (0, no scar visible, to 10, worst scar), patients scored their scar s as 1 for the needlescopic cases and 5 for the laparoscopic group. Li kewise, we have used needlescopic instruments to perform appendectomy, inguinal herniorrhaphy, adrenalectomy, splenectomy, and fundoplicatio n. In conclusion, needlescopic procedures are safe and efficient. Whil e they result in longer operative times, they decrease the need for po stoperative analgesia, which may shorten convalescence and improve the cosmetic result.