What is minimally invasive cholecystolithotomy? Cholecystolithotomy is actually a cholecystolithotomy. In recent years, with the advancement and promotion of laparoscopic technology and the increasing demand of patients for minimally invasive techniques, minimally invasive techniques are breaking through to all areas of traditional surgery. “minimally invasive” surgery. However, there is also a difference between minimally invasive and non-minimally invasive traditional biliary stone extraction surgery. Minimally invasive cholecystectomy based on traditional surgery should be: (1) incision of the abdominal wall under ultrasound positioning to minimize the abdominal wall incision; (2) incision of the bottom of the gallbladder in the direction of the blood vessels; (3) gauze strips around the gallbladder to protect it from bile flow into the abdominal cavity; (4) observation of the gallbladder cavity with a fiberoptic choledochoscope and removal of the stones under the scope with a mesh basket; (5) closure of the gallbladder incision with fine absorbable sutures in two successive layers. (5) The gallbladder incision is closed with two successive layers of fine absorbable sutures with a 1mm margin and a 2mm stitch distance; (6) No abdominal drainage is placed. It can be seen that minimally invasive cholecystectomy based on traditional surgery is not only limited to the size of the incision in the abdominal wall, but is more about the gentle and delicate manipulation of the gallbladder. When Bobbs performed the procedure, he used a rigid lithotripter to remove the stones blindly from the gallbladder, which not only failed to remove the stones, but also induced stone regeneration due to damage to the gallbladder mucosa. The sutures used at that time were coarse cotton threads (non-absorbable), which not only kept the cotton thread foreign body in the gallbladder for a long time, but also thickened the local gallbladder wall and caused adhesions, thus affecting the function of the gallbladder and eventually leading to recurrence of stones. Therefore, I believe that Bobbs’ surgical approach is correct and the high recurrence rate of stones is due to the backward technical conditions at that time. It is important to carry out bile-preserving lithotripsy with minimal invasiveness, especially fine manipulation. It is ideal to operate with non-invasive instruments under surgical magnification. A successful minimally invasive biliary lithotripsy should also include: strict indications: a thorough investigation of the patient’s medical history, lifestyle habits, concomitant diseases, gallstone status, and gallbladder function must be done before surgery. Those with a tendency for stone recurrence (poor gallbladder function, high number of stones, combined diseases such as diabetes and cirrhosis, family history of gallstones, poor lifestyle habits that are difficult to change, etc.) are not suitable for gallbladder preservation. Post-surgical prevention: prevention should be carried out for individualized causes of gallstone formation in patients, including improvement of living (dietary) habits, treatment of concomitant diseases, and post-surgical application of bile acid preparations in cases of gallbladder cholesterol deposition found during surgery.