Laparoscopic cholecystectomy.

Laparoscopic cholecystectomy is a new endoscopic technique that has diffused throughout the surgical community with great rapidity. Although the DATTA panelists considered the procedure appropriate with respect to both its safety and effectiveness, recognition was made that there are no comparative trials of this technique vs open cholecystectomy and virtually no literature on complication rates. The Society of American Gastrointestinal Endoscopic Surgeons has developed minimal credentialing criteria for determining competence in laparoscopic surgery. This includes completion of an approved residency training in general surgery, training in laparoscopic technique either by a surgeon experienced in this procedure or by completion of an approved course in the technique requiring hands-on laboratory practice, and observation or proctoring of an actual surgical procedure. Many of the DATTA panelists (35 of 40 [87.5%]) reiterated the importance of requiring that the procedure be performed first with animals and that subsequent laparoscopic procedures on patients be done under the supervision of an expert in laparoscopic cholecystectomy.