The needlescope or minilaparoscope was first utilized for diagnostic purposes. Therapeutic procedures using needlescopic instruments began in the mid 1990s. Gagner et al. described the technical aspects of needlescopic cholecystectomy, splenectomy, appendectomy, inguinal herniorrhaphy, adrenalectomy, and fundoplication [16]. Needlescopic surgery is defined as a procedure using less than 3-mm laparoscopic instruments.

Reduced port laparoscopic surgery (RPLS) is a recent concept that indicates a laparoscopic surgery aiming at both reducing the number of ports and reducing the diameter of the port. Reducing the number of ports means not only reducing the number of ports inserted to the abdominal cavity, but reducing the number of skin incision by collecting a couple of ports to one incision [17, 18]. Currently, a single-incision or single-port laparoscopic surgery is therefore considered to be included into the category of RPLS. Besides, the needlescopic surgery or minilaparoscopic surgery is also considered as a part of RPLS.