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J.Jpn. Surg. Soc.. 121(3): 294-300, 2020


Feature topic

REDUCED PORT SURGERY:LAPAROSCOPIC COLECTOMY IN NEEDLESCOPIC SURGERY

The Cancer Institute Hospital of JFCR, Colorectal Surgery Department, Gastroenterology Center, Japan, Tokyo

Shimpei Matsui, Yosuke Fukunaga, Satoshi Nagayama, Tsuyoshi Konishi, Takashi Akiyoshi, Toshiya Nagasaki, Tomohiro Yamaguchi, Toshiki Mukai

Needlescopic surgery (NS) is one type of laparoscpic surgery using a small-diameter instrument with an outer diameter of 2 to 3 mm and has attracted attention as a form of reduced port surgery. Reports of NS have been published since 1998 and have been increasing gradually. The benefits of NS include improved cosmetic results and reduced postoperative pain due to less abdominal wall damage. Furthermore, the surgical field preparation is similar to that of conventional laparoscopic surgery (CLS), and it is believed that the stress of surgeons is reduced as compared with single-incision laparoscopic surgery. Postoperative NS pain tends to decrease compared with CLS. In addition, from the viewpoint of long-term prognosis, the same results were obtained in both colon cancer and rectal cancer between NS and CLS. Although the grasping force is reduced and the surgical field is sometimes difficult to deploy due to the fineness of the forceps, the NS technique can be acquired with an appropriate learning curve. Laparoscopic surgeons should fully understand the instrument specificity to prevent the intraoperative and postoperative complications associated with NS. By learning how to use the devices effectively and avoid its potential complications, NS makes laparoscopic surgery less burdensome for patients.


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