[Laser laparoscopic cholecystectomy]

Clinical use of the Polish Nd-YAG laser with "naked fibre"--type tip in the laparoscopic cholecystectomy is discussed. Eleven subsequent patients with the symptomatic cholelithiasis confirmed with ultrasonography have been operated with this technique. Laser served mainly to dissect gall bladder from the liver. Biliary duct and cystic artery have been clipped. No complications of the laparoscopic laser cholecystectomy have been noted. Gall bladder wall has been perforated in 3 patients operated with contact technique. However, there have been no technical problems, and further preparation of the gall bladder has been successfully completed with laser in all cases. A value of laser in laparoscopic cholecystectomy seems lower than that of electrocautery. However, a non-contact photocoagulation in the hemostasis of blood vessels in gall bladder removal site seems promising. Laser prolongs the duration of surgery and markedly increases its cost. Further investigations are required to evaluate laparoscopic laser cholecystectomies as the effects of laser beam in the abdominal cavity remains unknown.