The advantages of laparoscopic cholecystectomy (LC) are based on its low invasiveness due to the small surgical wounds. If LC could be performed using fine-caliber instruments, these advantages would be amplified. We developed 3-mm-caliber instruments and performed LC in 20 patients using one 5-mm and two 3-mm instrument ports. The results were retrospectively compared with those of standard LC. The operating time (107.2 +/- 50.0 min), complication rate (0%), number of doses of analgesia (0.80 +/- 0.83), and postoperative hospital stay (4.9 +/- 1.2 days) were not significantly different between our method and standard LC. At 6 months postoperatively, the scars were smaller with our method. Surgery using fine-caliber instruments was no more difficult than standard LC and achieved a superior cosmetic outcome.