Re-Evaluation of Needlescopic Surgery

Nobumi Tagaya, PhD, Keiichi Kubota, PhD. Second Department of Surgery, Dokkyo Medical University, Tochigi, Japan

Background: Single port surgery (SPS) has gradually penetrated into the surgical field. However, we proposed the re-evaluation of needlescopic surgery (NS) to improve an esthetic result and postoperative quality of life of the patients and reduce costs and stress of surgeons, and evaluated the results of needlescopic surgeries in our department.

Methods: We experienced NS in 193 patients between May 1998 and August 2010. Their surgical procedures were cholecystectomy in 148 patients, bulectomy in 11, thyroidectomy and axillary lymph node dissection in each 10, splenectomy and abdominal wall hernia repair in each 3, appendectomy, adlenalectomy, unroofing of cyst in each 2, and lysis of adhesion and resection of gastric tumor in each one, respectively. Under general anesthesia, one 12-mm and 2 or 3 of 2- or 3-mm ports were introduced into the operative field. The specimen was retrieved from the 12-mm wound using a plastic bag.

Results: The procedure was successfully completed in all patients without the conversion to open procedure. Four (5.4%) of 148 cholecystectomies required an exchange to 5-mm instruments. There were no perioperative complications. Technical points were no direct organ mobilization to avoid organ injuries, the rotation of operating table and the utilization of organ gravity to create the better operative field, the minimum use of needlescope to perform safe maneuver and the improvement of bi-hand technique.

Conclusions: Needlescopic Surgery is a safe and feasible procedure to achieve a minimal invasive surgery. We should have better option of needlescopic surgery.