title: Needlescopic cholecystectomy: lessons learned in 10 years of experience.
abstract: OBJECTIVE
  Needlescopic cholecystectomy (NC) is a refinement of laparoscopic cholecystectomy (LC) using 2-mm instruments compared with the standard 5-mm and 10-mm ports. We review our experience with needlescopic cholecystectomy.
  
  
  METHODS
  From 1994 to 2004, 303 patients underwent NC. All patients were operated on using 2-mm instruments and one 10-mm trocar for the laparoscope. The characteristics of patients, total operation time, complications, postoperative pain, and hospital course were documented.
  
  
  RESULTS
  Patients' average age was 41.86 years; 262 were female and 41 were male. Mean BMI was 25.7. Mean length of surgery was 59.33 minutes. Intraoperative cholangiography was performed in all cases. Mean blood loss was 14.88 mL. One intraoperative complication occurred. Mean hospital stay was 22.68 hours. Postoperative pain was measured on a 0-10 pain scale; on day 0 it was 4.4 and on the first day it was 1.7. Analgesic doses required were 0 doses in 6.89%, 1 in 20.68%, 2 in 24.13%, 3 in 34.48%, 4 in 13.79%, and > 4 doses was not required. No postoperative complications occurred. At 3-month follow-up, patient satisfaction was 100%, and in 99% of patients scars were imperceptible.
  
  
  CONCLUSIONS
  NC is safe and feasible without increased operative risk, with better cosmetic results, less pain, and good acceptance among patients.
authors.affiliation: Texas Endosurgery Institute, San Antonio, Texas 78222, USA. texasendosurgery@texasendosurgery.com
authors.forename: Morris E
authors.initials: ME
authors.lastname: Franklin
authors.forename: Eduardo J
authors.initials: EJ
authors.lastname: Jaramillo
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Glass
authors.forename: Jorge M
authors.initials: JM
authors.lastname: Treviño
authors.forename: Keenan R
authors.initials: KR
authors.lastname: Berghoff
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain; D011183:Postoperative Complications; D013997:Time Factors