How I Do It: The Very First Laparoscopic Cholecystectomy as a First-Year Resident, with a Step-by-Step Tutorial

Abstract

Since its introduction in 1987, laparoscopic cholecystectomy (LC) has been widely performed by surgeons as a standard procedure for benign gallbladder diseases. Education and training by hepatobiliary experts are important in order to safely perform LC without critical complications. The present report discusses the first LC performed by a beginner surgeon who was trained with our institutional step-by-step tutorial. The step-by-step mentor-mentee tutorial had a total of four phases: video training, observation in the operating room, participation as an assistant, and finally performing LC independently. At every step, the mentor’s approval was required to move on to the next phase. After completing visual training and observation, the mentee participated in 10 consecutive LCs as an assistant or operator. Finally, LC for a 54-year-old female patient with gallbladder stones was independently performed by the mentee under the mentor’s supervision. The patient was discharged on the first postoperative day without complications. We report a case of LC successfully performed by a beginner surgeon with the aid of a newly established step-by-step tutorial. The tutorial is expected to be applied to numerous surgical trainees after further refinement regarding its safety and feasibility.