[Danger of monopolar current in laparoscopic gallbladder surgery]

Monopolar electrosurgery is querried because of the availability of new preparation-techniques in laparoscopic cholecystectomy. The advantage of simple handling, cheap application and high efficiency has to be set against the danger of tissue lesions e. g. the damage of the bile duct as demonstrated by four own cases. Especially the bipolar preparation-method and ultrasonic dissection are safer, but expensive and not as fast and effective as monopolar technique. Laser-heated instruments exist but are not in wide clinical use. The danger of tissue-lesions can be reduced by accurate preparation-principles and caution in dissection of the Calot-triangle.