General Surgical Laparoscopic Procedures for the “Nonlaparologist”

To assess our initial experience with a variety of laparoscopic procedures that can be performed by general surgeons with the basic skills used for laparoscopic cholecystectomy and without advanced laparoscopic expertise. We retrospectively reviewed a 36-month experience (1991 through 1994) at our institution with a consecutive series of patients who underwent basic laparoscopic surgical procedures but specifically excluding cholecystectomy, appendectomy, herniorrhaphy, and colectomy. Procedures performed laparoscopically included gastrostomy, jejunostomy, small bowel resection, intra-abdominal and retroperitoneal biopsy, staging of intra-abdominal malignant lesions, and adhesiolysis for relief of small bowel obstruction. During the 3-year study period, 106 patients underwent 107 procedures, 89 of which were successful. Four patients had substantial complications, two of whom underwent surgical repair. A spectrum of procedures may be safely performed with the skills learned from laparoscopic cholecystectomy and without the need for advanced laparoscopic skills such as intracorporeal suturing or tying of knots.