Laparoscopic cholecystectomy is an operation performed laparoscopically using special instruments. Two important ducts connected to the gallbladder, the cholecystic artery and the cholecystic duct, need to be disconnected and ligated at the same time when the gallbladder is removed. In traditional (open) cholecystectomy, doctors ligate these two ducts with silk wires, but in laparoscopic surgery, because it is more difficult to ligate them with instruments, various clamps are mostly used to close them clinically. Tian Mingguo, Department of Hepatobiliary Surgery, People’s Hospital of Ningxia Hui Autonomous Region The first clamps used were metal titanium clamps, which are less expensive, about 7-8 yuan each, and a total of 4 clamps were used. However, the use of titanium clips has been decreasing in recent years because they are metallic and can interfere with the patient’s future CT results and prevent MRI examinations. In order to avoid the shortcomings of metal titanium clips, plastic clips (biological clips) have been used in the clinic recently. The biggest advantage of these clips is that they are firmly clamped and do not show up under radiation, but the disadvantage is that the material is not absorbed and stays in the body for a long time. The other non-metallic clips used clinically are absorbable clips, made of absorbable material, absorbed in the body for about 180 days. There is no in-depth study yet. (Below white is plastic clip, black is absorbent clip release) With the rapid progress of biomaterial research, clips more in line with human surgical needs will also come into being. On the other hand, with the improvement of laparoscopic operation technology, more hospitals in China have already adopted the surgical wire ligation technique and avoided the use of closure clips, making laparoscopic cholecystectomy closer to the traditional operation on the basis of minimally invasive, and the effect of surgical wire has been clinically proven for centuries. The use of surgical wire tying not only reduces the cost of surgery, but more importantly, avoids the need to keep those “modern materials” in the body, and therefore will be the direction of laparoscopic cholecystectomy and other laparoscopic procedures. Tying the knot with instruments is difficult to perform and requires more skill from the surgeon. (Tian Mingguo)