Pioneers in laparoscopic hepato‐biliary‐pancreatic surgery

Laparoscopic operations have become widespread in the field of digestive surgery, and many surgical procedures are now performed laparoscopically. Although laparoscopic operations have several limitations, such as a two-dimensional view, lack of tactile sensation, requirement for special surgical skills, and the high cost of equipment, their advantages include less postoperative pain, quicker recovery to daily life, and a wide view that enables delicate maneuvers have facilitated spread of this procedure. The first laparoscopic procedure was performed by the German surgeon Kelling in 1901 using dogs 1. He inflated a canine's abdomen with air and observed the abdominal cavity using a cystoscope. In 1910, Jacobaeus in Sweden performed the first laparoscopic examination in a human 1. In the 1960s and 1970s, laparoscopy was developed as a part of gynecological practice. Gynecologists began to use laparoscopy for sterilization, ovarian cystectomy, and pelvic adhesiolysis. On 13 September 1980, the German gynecologist Semm performed the first laparoscopic appendectomy 1. This was the first digestive surgery to be performed under laparoscopy. Although some surgeons criticized him, other surgeons were fascinated by his achievement. Hepato-biliary-pancreatic (HBP) surgery is among the most challenging procedures because of the anatomical complexity, diversity of diseases, and high morbidity rates; nevertheless, laparoscopic HBP surgery has become a treatment option in daily clinical practice. The success of laparoscopic HBP surgery has been made possible by numerous pioneer surgeons who started with laparoscopic cholecystectomy (LC), and laparoscopic HBP surgery is still evolving to increasingly more complex procedures. We herein look back on pioneers who have made great achievements in laparoscopic HBP surgery. Laparoscopic cholecystectomy was the first laparoscopic HBP surgery and is widely accepted as a minimum invasive surgery (MIS) in the HBP field. On 12 September 1985, Mühe of Erlangen, Germany performed the first LC in a woman with gallstones using a direct vision scope, which he called the "galloscope" 1. Mühe presented his procedure at the Congress of the German Surgical Society in April 1986; however, his audience was skeptical regarding his claims, and he even received derogatory remarks such as "small brain–small incision." In 1992, 7 years after his first LC, Mühe received an award in recognition for his work by the German Surgical Society. Around the same time period, Mouret, a French surgeon from Lyon, shared his practice with a gynecologist and thus had access to laparoscopic instruments and patients requiring laparoscopy 1. Mouret performed his first laparoscopic appendectomy in 1983, and in March 1987, he operated on a woman with both a gynecological disorder and gallstones using video laparoscopy. Mouret's procedure inspired Dubois of Paris University and Perissat of Bordeaux University. Dubois performed his first LC in April 1988 and published the first report of LC in the French journal La Presse Médicale in May 1989. Perissat performed his first LC in October 1988. Although his paper was not accepted, Perissat showed his video of LC at the industry booth of the Society of American Gastrointestinal and Endoscopic Surgeons meeting in April 1989. His video attracted many surgeons' attention. Perissat published the first English report of LC in Endoscopy in December 1989. Although Mühe was the first surgeon to perform LC, the source of the current LC technique was Mouret's procedure. The employment of video laparoscopy contributed to the spread of LC. The spread of laparoscopic surgery soon surged worldwide. In the USA, McKernan and Saye performed the first LC with a video laparoscope in North America on 22 June 1988 1. On 29 May 1990, Yamakawa et al. performed the first LC in Japan 2. Laparoscopic cholecystectomy soon became the standard procedure for the treatment of gallbladder stones. In September 1992, during the National Institutes of Health Consensus Development Conference, LC was reported to be a safe and effective treatment for most patients with symptomatic gallstones and had become the treatment choice for many patients in comparison with open cholecystectomy 3. In 1995, Strasberg et al. analyzed the causes of biliary injury during LC and proposed the "critical view of safety," which paved the way for the culture of safety in LC 4. The popularization of LC also increased the diagnosis of common bile duct stones using intraoperative cholangiography. In March 1991, Spaw et al. and Petelin independently reported laparoscopic common bile duct exploration in Surgical Laparoscopy this case was published in Surgical Endoscopy in May 1994. The first laparoscopic pancreatoduodenectomy for malignancy was reported by Uyama et al. They performed laparoscopic pancreatoduodenectomy for distal bile duct cancer on 13 July 1994. They published one report in the Journal of the Japan Society for Endoscopic Surgery (in Japanese) in April 1996 and another in Surgical Laparoscopy rather, they are an evolving and dynamic result of multiple collaborations from different physicians and scientists spanning several generations. Today, the advantages of laparoscopic surgery are undisputed. However, when innovating novel techniques in HBP surgery, we must always consider our patient's safety and our Hippocratic oath, "Primum non nocere" (first, do no harm). We gratefully appreciate the useful advice and suggestions provided by Professor Taizo Kimura, Professor Keiji Sano, Professor Hiroki Yamaue, Professor Masakazu Yamamoto, and Honorary Professor Tadahiro Takada, the Founding President of the Japanese Society of Hepato-Biliary-Pancreatic Surgery, who proposed concept and general plan of "East meets West: Historical Perspective in HBP surgery & IVRs." We also thank the International Scientific Advisor Professor Steven M. Strasberg for providing valuable comments and information on the history of laparoscopic HPB surgery. The contents of this manuscript were presented at the Joint Congress of the 6th Biennial Congress of the Asian-Pacific Hepato-Pancreato-Biliary Association and the 20th Meeting of the Japanese Society of Hepato-Biliary-Pancreatic Surgery, 7–10 June 2017, Yokohama, Japan. None declared.