title: Mini-laparoscopic appendectomy using a needle loop retractor offers optimal cosmetic results.
abstract: BACKGROUND
  Do conventional laparoscopic appendectomy (LA) techniques provide truly satisfying results for patients and surgeons? We have devised a more advanced technique that improves cosmesis.
  
  
  METHODS
  A 2-mm scope is inserted at the umbilicus, and a 12-mm working trocar is inserted through a suprapubic incision placed below the line of pubic hair. A needle loop retractor (NLR) is inserted to hold the appendix in the lower right abdomen. In this NLR, a stainless steel wire is placed within a needle having a diameter of 2 mm. From the suprapubic trocar, a bipolar coagulator is inserted to transect the appendiceal mesentery. A series of 30 patients underwent this procedure.
  
  
  RESULTS
  There were no conversions to laparotomy and no intra- or postoperative complications.
  
  
  CONCLUSIONS
  Laparoscopic appendectomy using a 2-mm scope, suprapubic trocar, and an NLR yields optimal cosmetic results. For surgeons, the NLR allows the appendix to be held more firmly than then a 5- or 2-mm grasping forceps is used.
authors.affiliation: Department of Critical Care Medicine, Iwate Medical University, School of Medicine, 19-1 Uchimaru, Morioka 020-8505, Japan. satonobu@iwate-med.ac.jp
authors.forename: N
authors.initials: N
authors.lastname: Sato
authors.forename: M
authors.initials: M
authors.lastname: Kojika
authors.forename: Y
authors.initials: Y
authors.lastname: Yaegashi
authors.forename: Y
authors.initials: Y
authors.lastname: Suzuki
authors.forename: M
authors.initials: M
authors.lastname: Kitamura
authors.forename: S
authors.initials: S
authors.lastname: Endo
authors.forename: K
authors.initials: K
authors.lastname: Saito
mesh_terms: D000328:Adult; D001062:Appendectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D002921:Cicatrix / Q000517:prevention & control*; D004867:Equipment Design; D004954:Esthetics; D005260:Female; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009339:Needles; D011446:Prospective Studies