A kinder cut for gallbladder surgery.

Removing a diseased gallbladder through a small, video-camera-guided tube called a laparoscope is just as safe and effective as extracting the organ through a large abdominal incision, a panel of surgeons concluded last week.

Moreover, the panel -- convened by the National Institutes of Health in Bethesda, Md. -- agreed that laparoscopic cholecystectomy, or gallbladder removal, involves less postoperative pain and a shorter hospital stay than do traditional open-surgical techniques. Because the new procedure requires only tiny incisions, patients who undergo laparoscopic cholecystectomy recover faster and go back to work sooner than those who undergo open surgery, the panel found.

The panel added, however, that only patients with symptomatic gallstones -- who experience nausea, vomiting, or recurring bouts of severe pain in the upper-right abdomen -- should undergo any type of gallbladder removal. Physicians should first try to dissolve the stones of patients who have only occasional symptoms, either with oral bile acid medications or with shock-wave lithotripsy, a technique that shatters gallstones with sound waves, the panel said.

The panel reached its conclusions during a NIH Consensus Development Conference.