[Risk and responsibility in celiosurgery]

Not performing laparoscopic surgery is not a dishonour. Likewise, it is not shameful to convert a laparoscopic operation to conventional laparotomy. The mission of the surgical community is to avoid inhibiting progress while assuring patient safety. Based on accepted standards, experts designated by the courts establish a report on the pre, per and postoperative procedures to enlighten the judge who decides on the notion of responsibility in the specific context of laparoscopic surgery. The aim of this work was to inform the practicing surgeon on the known complications, prevention of accidents, the forensic classification and the current estimation of risk. Statistically, laparoscopic surgery is not an accrued risk for insurance companies. Practicians should know that there are specific potential risks involved in this technique which are expressed as a function of the surgeons behaviour before, during and after the operation. Effective training in laparoscopic surgery which reproduces the same action as conventional surgery, but with different procedures, requires, as for conventional surgery regular "fellow" training. The trained, competent, conscientious surgeon can propose the advantages of laparoscopic surgery to his patients while avoiding the disadvantages.