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The answering opposite party, in the capacity of anesthetist was called by the hospital to examine and administer anaesthesia for a Laparoscopic Cholecystectomy. Answering opposite party was performing his duty to the best of his abilities and he cannot be held responsible for any miss happenings taking place during the surgery particularly when the role of the answering opposite party was confined to the administration of anaesthesia which is not the cause of death. The answering opposite party reached nursing home at 2:40 and administered general anaesthesia to the patient as per standard practice during Laparoscopic and after few minutes when the operating surgeon put the laparoscope inside the abdomen profuse bleeding was found. The bleeding inside the abdomen was such which was impossible to stop by Laparoscope, hence operating surgeon decided to opt for open surgery to find out and repair the ruptured vessel, as such the role of the answering opposite party was limited to administering anaesthesia to the patient and to maintain the vitals of the patient during the entire operation. The complainant has not made any specific allegation against the answering opposite party. In order to show the breach of duty, the burden lies on the complainant , first to show what is considered as reasonable care under the given circumstances and then to show the conduct of the answering opposite party was below such a degree of care. The answering opposite party has completed his degree of MBBS from Moti Lal Nehru Medical College  , Allahabad in the year 1981 and subsequently got himself registered with  'The Medical Council of the Uttar Pradesh  ' . After rendering almost 30 years is spotless service the answering opposite party retired from Provincial Medical Services As Senior Consultant Anaesthesiology upon attaining the age of superannuation.

                                               Veress needle Whereas it is true that no operation has been more profoundly affected by the advent of laparoscopy than cholecystectomy has, it is equally true that no procedure has been more instrumental in ushering in the laparoscopic age than laparoscopic cholecystectomy has. Laparoscopic cholecystectomy has rapidly become the procedure of choice for routine gallbladder removal and is currently the most commonly performed major abdominal procedure in Western countries. [1]   A National Institutes of Health (NIH) consensus statement in 1992 stated that laparoscopic cholecystectomy provides a safe and effective treatment for most patients with symptomatic gallstones and has become the treatment of choice for many patients. [2] This procedure has more or less ended attempts at noninvasive management of gallstones.

Although direct operating room and recovery room costs are higher for laparoscopic cholecystectomy, the shortened length of hospital stay leads to a net savings. More rapid return to normal activity may lead to indirect cost savings. [5] Not all such studies have demonstrated a cost savings, however. In fact, with the higher rate of cholecystectomy in the laparoscopic era, the costs in the United States of treating gallstone disease may actually have increased.

Trials have shown that laparoscopic cholecystectomy patients in outpatient settings and those in inpatient settings recover equally well, indicating that a greater proportion of patients should be offered the outpatient modality. [6]   Laparoscopic cholecystectomy has received nearly universal acceptance and is currently considered the criterion standard for the treatment of symptomatic cholelithiasis. [7, 6] Many centers have special "short-stay" units or "23-hour admissions" for postoperative observation following this procedure. [6]   Data from all over the world have, however, shown that the risk of a bile duct injury (BDI) during laparoscopic cholecystectomy is about 0.5%--that is, about two the three times the risk previously reported for open cholecystectomy. [8]   surgery through small incisions.

Symptomatic gallstone disease Biliary colic with sonographically identifiable stones is the most common indication for elective laparoscopic cholecystectomy. [10, 13]   Acute cholecystitis, if diagnosed within 72 hours after symptom onset, can and usually should be treated laparoscopically. Beyond this 72-hour period, inflammatory changes in surrounding tissues are widely believed to render dissection planes more difficult. This may, in turn, increase the likelihood of conversion to an open procedure to 25%. Randomized control trials have not borne out this 72-hour cutoff and have shown no difference in morbidity when the procedure is performed by expert and experienced surgeons. Other options include interval laparoscopic cholecystectomy after 4-6 weeks and percutaneous cholecystostomy. [14, 15, 16]   Biliary dyskinesia should be considered in patients who present with biliary colic in the absence of gallstones, and a cholecystokinin-diisopropyl iminodiacetic acid (CCK-DISIDA) scan should be obtained. The finding of a gallbladder ejection fraction lower than 35% at 20 minutes is considered abnormal and constitutes another indication for laparoscopic cholecystectomy. [17] Complex gallbladder disease Gallstone pancreatitis Once the clinical signs of mild-to-moderate biliary pancreatitis have resolved, laparoscopic cholecystectomy can be safely performed during the same hospitalization. Patients diagnosed with gallstone pancreatitis should first undergo imaging to rule out the presence of choledocholithiasis. This can be achieved by means of preoperative US, magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP), endoscopic US (EUS), or intraoperative cholangiography (IOC). [18]   In cases of acute moderate-to-severe biliary pancreatitis (according to the Ranson criteria), laparoscopic cholecystectomy should be delayed. [19]   Choledocholithiasis The following treatment options are available for patients found to have choledocholithiasis: