[NEEDLESCOPIC SURGERY].

We define needlescopic surgery (NS) as endoscopic surgery performed with 2- to 3-mm needlescopic instruments, and it has received attention as a form of reduced-port surgery. Reports on NS have been published since 1998, and their number has gradually increased. A Japanese study group called the “Needlescopic Surgery Meeting” was established in October 2000. The advantages of NS are improved cosmetic results and reduced postoperative pain. Although the cosmetic results of NS are inferior to those of single-incision endoscopic surgery, the creation of an operative field is similar to that using the conventional method, and NS involves less stress on surgeons. In the comparison of postoperative pain among conventional, single-incision, and needlescopic techniques, the amount of postoperative analgesics required after the needlescopic technique is significantly (p＜0.001) less than that after the other techniques. The disadvantages of NS are the poorer image quality of the needlescope, difficulty in grasping due to the fine shaft of the instruments, and difficulty in creating the operative field. If we understand the specific details of needlescopic instruments and endeavor to use them properly to avoid intra- and postoperative complications, NS will become more advanced in cooperation with single-incision endoscopic surgery.