Video endoscopic surgery in the community hospital.

After proper training and observation, I started performing laparoscopic cholecystectomy at the community hospital in August 1990. Since then, and after further advanced training, I have performed 172 procedures, including appendectomy, hernia repair, lysis of adhesions, retroperitoneal biopsy, paraesophageal hernia repair, exploration of the common bile duct, repositioning of CAPD catheters, and colon resection with excellent results. This experience confirms that video endoscopic surgery can become the approach of choice in the community for many of what today are still considered open procedures, without undue risk, as long as adequate training is obtained and proper preparation observed when more advanced procedures are attempted.