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Laparoscopic Cholecystectomy

Geza J. Jako, MD; Istvan Rozsos, MD, PhD
JAMA. 1991;266(6):796-797. doi:10.1001/jama.1991.03470060058021.
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To the Editor.  —A recent editorial1 and Diagnostic and Therapeutic Technology Assessment (DATTA) report2 considered the treatment of uncomplicated cholelithiasis by laparascopic cholecystectomy as effective and safe. The major contribution of this less invasive and quasi-microsurgical procedure is the greatly reduced postoperative pain. Speedier recovery benefits patients, health care systems, and a country's economy. Complications during the learning period may be slightly higher since surgeons are accustomed to viewing intra-abdominal structures three dimensionally, and in laparoscopic cholecystectomy they operate using a two-dimensional television monitor with somewhat unnatural colors. These drawbacks are compensated for by the magnified view through the television system.Over half a million cholecystectomies are performed annually in the United States. On a global basis this would translate into millions performed in thousands of hospitals. The unit cost of new equipment is $35 000 to $50 000, which more than doubles if yttrium-aluminum-garnet (YAG) or potassium-titanyl-phosphate


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