Minimal access surgery has been rapidly growing. It is essential that it be carefully evaluated and that quality assurance programs be developed. Indications for surgery should not be changed just because less invasive surgical techniques are available. Conversion to an open procedure may be required in any patient, and the risk in gallstone patients is higher in the elderly. The benefits of laparoscopic methods applied to the management of symptomatic gallstone disease in the older patient population appear clear. Similar evaluation is appropriate for each new procedure performed using new techniques.
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