title: Randomized trial of needlescopic versus laparoscopic cholecystectomy.
abstract: BACKGROUND
  Several studies have reported the feasibility of using 'needlescopic' instruments with a diameter less than 3 mm in minimally invasive surgery. This study reports a comparison of needlescopic cholecystectomy and laparoscopic cholecystectomy.
  
  
  METHODS
  Seventy-five patients with symptomatic chronic cholelithiasis were randomized to needlescopic (n = 37) or laparoscopic (n = 38) cholecystectomy.
  
  
  RESULTS
  The duration of surgery in the two groups was similar. Patients in the needlescopic group had less pain (mean visual analogue score 2.2 versus 3.6; P < 0.003) and had smaller scars (median length 17.0 versus 25.0 mm; P < 0.001). In addition, patients in the needlescopic group tended to require fewer intramuscular pethidine injections (P = 0.05). However, oral analgesic requirements in the two groups were similar. There were no complications in either group.
  
  
  CONCLUSIONS
  Needlescopic cholecystectomy resulted in less postoperative pain and a smaller surgical scar than laparoscopic cholecystectomy in patients with chronic cholecystitis.
authors.affiliation: Minimally Invasive Surgical Centre, Department of Surgery, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074.
authors.forename: W K
authors.initials: WK
authors.lastname: Cheah
authors.forename: J E
authors.initials: JE
authors.lastname: Lenzi
authors.forename: J B
authors.initials: JB
authors.lastname: So
authors.forename: C K
authors.initials: CK
authors.lastname: Kum
authors.forename: P M
authors.initials: PM
authors.lastname: Goh
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002769:Cholelithiasis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology