Needlescopic surgery - A logical evolution from conventional laparoscopic surgery

Background: The purpose of this study was to analyze the safety and feasibi lity of needlescopic surgery and to compare the short-term outcomes relativ e to conventional laparoscopic surgery. Methods: Needlescopic surgery patients were compared to matched cohorts of conventional laparoscopic surgery patients from the same prospective databa se for a variety of selected procedures. Results: A total of 101 needlescopic procedures were analyzed (30 cholecyst ectomy, 28 Nissen fundoplication, 12 bilateral sympathectomy, 10 splenectom y, 10 Heller myotomy, three adrenalectomy, two colon resection, two splenic cyst excision, four other). There was no significant difference between th e needlescopic and conventional laparoscopic groups in conversion rates, mo rbidity, or mortality. A higher proportion of patients were in hospital < 2 4 h for needlescopic splenectomies (40% vs 0%, p = 0.087), fundoplications (68% vs 42%, p = 0.107), and myotomies (90% vs 30%, p = 0.022) than for con ventional laparoscopic surgery. Operative times were significantly shorter for needlescopic sympathectomy than for laparoscopic sympathectomy and Hell er myotomy (p = 0.004 and 0.013, respectively), and they were equivalent fo r other procedures. Conclusion: Needlescopic surgery can be performed in a variety of procedure s with no apparent increase in conversions, operative time, morbidity, or m ortality. There is a trend toward reduced hospital stays for certain proced ures. Randomized prospective trials comparing needlescopic to conventional laparoscopic surgery are still needed to confirm and/or extend our findings .