title: Single-incision laparoscopic cholecystectomy with needle graspers.
abstract: OBJECTIVE
  Single-incision laparoscopic cholecystectomy (SILC) is a promising alternative to standard multi-incision laparoscopic cholecystectomy (LC). However, generalization of SILC is still hampered by technical difficulties mainly associated with the lack of trocars used for retraction of the gallbladder. We therefore developed a modified method of SILC with the use of needle graspers (SILC-N) for optimal retraction and exposure.
  
  
  METHODS
  In addition to two trocars inserted through a single transumbilical incision, two needle ports were placed on the right subcostal and lateral abdominal wall, through which needle graspers were used for retraction of the gallbladder. Since December, 2009, 12 patients with symptomatic cholelithiasis were treated by SILC-N.
  
  
  RESULTS
  SILC-N was successfully performed in all but one patient requiring a conversion to the 4-port LC with a mean operative time of 71.5 (48-107) minutes. None of the patients experienced intraoperative or postoperative complications. The transumbilical incision and pinholes for needle graspers were almost invisible on discharge.
  
  
  CONCLUSIONS
  Our preliminary results suggest that SILC-N is a simple, safe and feasible technique of cholecystectomy offering similar postoperative recovery and better cosmetic outcome as compared to conventional LC.
authors.affiliation: Department of Surgery, Fukuoka Red Cross hospital, Fukuoka, Japan.
authors.forename: Kinjiro
authors.initials: K
authors.lastname: Sumiyoshi
authors.forename: Norihiro
authors.initials: N
authors.lastname: Sato
authors.forename: Shin
authors.initials: S
authors.lastname: Akagawa
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Hirano
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Koikawa
authors.forename: Kohei
authors.initials: K
authors.lastname: Horioka
authors.forename: Keigo
authors.initials: K
authors.lastname: Ozono
authors.forename: Kenji
authors.initials: K
authors.lastname: Fujiwara
authors.forename: Masao
authors.initials: M
authors.lastname: Tanaka
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sada
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation*; D002769:Cholelithiasis / Q000601:surgery*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D013525:Surgical Instruments; D016896:Treatment Outcome