Important features in laparoscopic cholecystectomy

Laparoscopic cholecystectomy (LC) was first introduced in 1987 by Du Bois (1). However, the first publication in literature belongs to Langenbuch from 1882 (2). It became the preferred method in America and Europe after 1990. It has been widely used in our country since 1992-1993. LC has advantages that cause less discomfort to the patient, short hospital stay, no wound problem or minimal, and bring the patient to society and business life in a short time. Cosmetic results are excellent. However, despite these advantages, there are also risks. These are: - The extension of the bile duct combined with the upward traction of the gallbladder can be perceived as a "long cystic duct" as a false impression. - Wound care and labor is less. - The surgeon's eye (ie camera) is at the level of the portal hepatis. - There is no need to retract the liver, colon and edion as in the open. The upper third of the hepatic canal and the liver hilum sometimes cannot be visualized very well. Because there is no "perception of depth". - It is difficult to perceive the distance between the right hepatic canal and the cystic canal. - In open cholecystectomy, we can clearly reveal the intersection of the bile duct associated with the cystic duct. In laparoscopic cholestectomy: the view of the bile duct combined with the camera in the umbilicus is tangential. This should be borne in mind during LC. If necessary, if we turn the lower right trocar to 10 by umbilical laaroscopy and reveal it, the vision becomes more perfect.