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The first laparoscopic cholecystectomy, performed by Prof. Philippe
Mouret in 1987 and described by himself in the first chapter of
this book, was an event that revolutionized surgery in the past few
decades. Although the majority of surgeons today are unfamiliar
with the his- ry of early minimally invasive surgery developments,
it is important to realize that the advent of laparoscopy led not
only to new surgical te- niques, but also to a change in the
doctrine of medical care, by streng- ening the concept of minimal
invasiveness. This is particularly the case for biliary lithiasis,
for which laparoscopy has provided major benefits in terms of both
diagnosis and surgical tre- ment. However, our understanding of the
etiology of this disease, as well as the availability of effective
medical therapies, have remained subst- tially unchanged over time.
The application of the innovative approach has not been, in routine
practice, without problems: between 1990 and 2000, the rate of
serious complications from laparoscopic cholecystectomy were four
times higher than those observed with open surgery. Even initial
attempts at lapa- scopic treatment of biliary common bile duct
stones resulted in excessive complications and associated
medico-legal problems. Nonetheless, today, most indications have
been stated, techniques have been standardized, and a new aspect to
the treatment of biliary lithiasis has appeared.
The first laparoscopic cholecystectomy, performed by Prof. Philippe
Mouret in 1987 and described by himself in the first chapter of
this book, was an event that revolutionized surgery in the past few
decades. Although the majority of surgeons today are unfamiliar
with the his- ry of early minimally invasive surgery developments,
it is important to realize that the advent of laparoscopy led not
only to new surgical te- niques, but also to a change in the
doctrine of medical care, by streng- ening the concept of minimal
invasiveness. This is particularly the case for biliary lithiasis,
for which laparoscopy has provided major benefits in terms of both
diagnosis and surgical tre- ment. However, our understanding of the
etiology of this disease, as well as the availability of effective
medical therapies, have remained subst- tially unchanged over time.
The application of the innovative approach has not been, in routine
practice, without problems: between 1990 and 2000, the rate of
serious complications from laparoscopic cholecystectomy were four
times higher than those observed with open surgery. Even initial
attempts at lapa- scopic treatment of biliary common bile duct
stones resulted in excessive complications and associated
medico-legal problems. Nonetheless, today, most indications have
been stated, techniques have been standardized, and a new aspect to
the treatment of biliary lithiasis has appeared.
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