Although laparoscopic cholecystectomy is a safe procedure, the rate of conversion to open cholecystectomy is still substantial. The conversion rate depends both on the indication and intraoperative complications. There is still a 10.38% morbidity associated with the procedure; however, the incidence of common bile duct injuries, which decreases with growing laparoscopic experience, was relatively low.

The TAPP hernia repair yields comparable or better results than Shouldice herniorrhaphy in terms of postoperative pain, recovery, and recurrence rate.

Spillage of gallstones after laparoscopic cholecystectomy is fairly common and occurs in about 6% of patients. However, abscess formation with subsequent surgical therapy remains a minor problem. Removal of spilled gallstones is therefore not recommended for all patients, but an attempt at removal should be performed whenever possible.

Background/Aims: Since its introduction in 1983, laparoscopic appendectomy (LA) has not replaced the conventional open procedure. The patient benefit seems limited to a decreased wound infection rate, and the overall morbidity and mortality rates remain equal to those of open appendectomy. Methods: The data (collected by the Swiss Association of Laparoscopic and Thoracoscopic Surgery) from 2,179 patients undergoing LA at 84 surgical institutions in Switzerland between January 1995 and December 1997 were retrospectively analyzed. Results: More than 90% of all patients had no intra- or postoperative complications. However, perforated appendicitis was associated with more complications, in particular a threefold increased wound infection rate (9.2 vs 3.5%). Furthermore, the conversion and reoperation rates of perforated appendicitis were significantly increased compared to ’simple’ acute appendicitis (25.5 and 10.4% vs 4.8 and 2.1%, respectively). LA performed with a stapling device is superior to LA performed with loops, although the difference is not significant. Conclusion: Therefore, LA is a safe and effective procedure. The postoperative morbidity and mortality rates are comparable to those of open appendectomy, which is still the most commonly used procedure in Switzerland. The question of whether perforated appendicitis is better treated laparoscopically or by the open procedure cannot be answered with our data.

Laparoscopic hernia repair causes less pain than the conventional operation and enables the patient to return to full work and usual activities earlier. The recurrence rate will not be known for 5 years.