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Laparoscopic Cholecystectomy

Bruce M. Wolfe, MD
JAMA. 1991;266(6):797-798. doi:10.1001/jama.1991.03470060058023.
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In Reply.  —Jako and Rozsos describe an alternative limited-access technique to laparoscopic cholecystectomy in which the need for carbon dioxide insufflation is replaced by retraction on the anterior abdominal wall. This technique may have merit as an adjunct to laparoscopic cholecystectomy in cases in which the pneumoperitoneum cannot safely be established or fails for technical reasons. Potential disadvantages to Jako and Rozsos' technique include the need for a larger upper abdominal incision and limitations to the extent to which complete inspection of the peritoneal cavity can be accomplished. It is doubtful that Jako and Rozsos' procedure is more economical than laparoscopic cholecystectomy, as specialized instruments and optical systems are required. The insufflator is the least expensive of the components needed for laparoscopic cholecystectomy. Disposable trocars and clip appliers as well as lasers are not needed for safe accomplishment of laparoscopic cholecystectomy.1Schonberg has concluded, based on the DATTA report,


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