The Evolution of Minimal Access Surgery and the Laparoscopic Cholecystectomy Ndungu BM

School of Medicine, University of Nairobi



Surgery is the first and the highest division of the healing art, pure in itself and perpetual in its applicability (1). In its history, large incisions were an absolute necessity to a successful procedure. Exposure was the key to a safe and successful operation. Surgeons have traditionally attempted to find new methods to treat their patients' afflictions while reducing the injury caused by the treatment hence the evolution of minimally invasive techniques. Access to body cavities in order to undertake surgical procedures by other means than making a large cut has been a technique waiting for its time(2). Though exposure is still essential for a safe and successful operation, it is now possible to access body cavities to perform surgical operations by making smaller incisions; the fundamental concept of minimal access surgery. Minimally invasive surgery may be as old as humanity itself. The holy bible mentions the ‘operation’ of Eve’s creation and the possibly the first ‘endoscopy’ where “The King of Babylon stood at the parting of the ways, to use divination, he made his arrows bright, he consulted with images, he looked in the liver” (3, 4).


The Annals of African Surgery is the official publication of the Surgical Society of Kenya.


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