Introduction: The spread of laparoscopia has required surgeons to familiarize with a completely
new surgical method and by today this method has clearly become of major importance
in gastrointestinal surgery. The evolution of laparoscopic cholecystectomy offers
many good lessons to learn for the purposes of advanced laparoscopic surgeries and
surgeons may benefit from this experience in any process of introducing new minimal
invasive techniques.
Methods and Material: We have made a retrospective analysis of the data of the cholecystectomies made right
after laparoscopia had become a widely spread, routine surgical method (1993) as well
as 14 years later (2007). The data have been processed using the SPSS 16.0 application
package. Significance levels have been established with the chi-square probe.
Results: Within the analised timeframe we could clearly see a growing use of laparoscopic
techniques (52,09% vs. 90,13%) with a growing number of cases (263/304), unchanged
average age (53,5 years) and constant male/female ratio (75/25%). The BMI increased
moderately (26,5 vs. 27,6), but the frequency of laparoscopic interventions on extremely
obese patients grew (BMI:25–30:25,5% vs. 33%, 30–35:10,6% vs. 16%, 35–40:2% vs. 4,2%)
while the postoperative hospitalization decreased dramatically from 5,9 days to 2,3.
In 1993 patients spent on the average 2,9 days in hospital after a laparoscopic surgery,
as long as in 2007 nearly 25% of the patients left the hospital 1 day after surgery.
The duration of a laparoscopic surgery decreased from 78 minutes to 53, and the occurrence
of intraoperative complications also decreased. The conversion ratio increased from
2,7% to 4,9%. In 3% of the laparoscopic cholecystectomies only 3 ports were used.
Discussion: As surgeons have come to master the new technique, the previous relative and absolute
pros and cons have been revised and at present 90% of cholecystectomies are made using
laparoscopia. The data collected in the analysis of laparoscopic techniques can be
used to research, learn and eventually introduce NOTES.
