title: Towards scarless surgery: a novel laparoscopic cholecystectomy by using 2-mm needle-shape instruments without trocar.
abstract: OBJECTIVE
  We introduce a new laparoscopic cholecystectomy by using 2-mm needle-shape instruments and compare it with single-incision laparoscopic cholecystectomy.
  
  
  METHODS
  From January 2011 to June 2011, 60 patients who satisfied the inclusion and exclusion criteria were prospectively selected and randomized to receive either a scar-hidden novel laparoscopic cholecystectomy (NLC group) (n=30) or a single-incision laparoscopic cholecystectomy (SILC group) (n=30). Their operation time, pain score, and satisfaction score were contrasted.
  
  
  RESULTS
  All operations were successful. Two patients were converted to conventional three-port laparoscopic cholecystectomy in the SILC group. No postoperative complications occurred in both groups. The operation time was significantly lower in the NLC group (14.17±3.51 minutes in the NLC group versus 24.67±4.12 minutes in the SILC group, P<.01). As to the satisfaction score, the NLC group was superior to the SILC group (4.53±0.57 in the NLC group versus 4.07±0.52 in the SILC group P<.01). There was also a lower postoperative pain score in the NLC group, although the results did not reach statistical significance.
  
  
  CONCLUSIONS
  The new scar-hidden laparoscopic cholecystectomy is a safe and feasible technique. Compared with single-incision laparoscopic cholecystectomy, it has a lower operation time and less difficulty but a higher satisfaction score. It demonstrates a new approach for minimal invasive surgery.
authors.affiliation: Department of Minimally Invasive Surgery, East Hospital of Tongji University, Shanghai, PR China. huhailc@sina.com
authors.forename: Hai
authors.initials: H
authors.lastname: Hu
authors.forename: An An
authors.initials: AA
authors.lastname: Xu
authors.forename: Anhua
authors.initials: A
authors.lastname: Huang
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000295:instrumentation*; D002921:Cicatrix / Q000209:etiology / Q000517:prevention & control*; D004867:Equipment Design; D006801:Humans; D008875:Middle Aged; D009339:Needles; D011446:Prospective Studies; D013525:Surgical Instruments