Laparoscopic cholecystectomy: past, present, and future

Laparoscopic cholecystectomy is one of the most commonly undertaken procedures in General Surgery with more than 500,000 performed annually. Overall, the complication rate is less than 1.5%, and the mortality rate is less than 0.1%. As such, laparoscopic cholecystectomy was considered by most to be at its zenith since its inception in the early 1990 s. Advancements in technology and equipment have opened new doors to physicians and allowed the laparoscopic cholecystectomy to once again evolve. Traditional four-port cholecystectomy has given way to three- and even two-port techniques. Standard 12-mm ports have been replaced by 2-mm ports, and experiments have now been implemented to achieve cholecystectomy with no ports-known as the transgastric technique. The authors reviewed evolution of these techniques that included a synopsis of our experience with the three-port cholecystectomy, as well as the future direction of laparoscopic surgery.