For cosmetic purposes, it is possible to perform an elective cholecystectomy through a transverse incision of no more than 5 cm. Access is obtained lengthwise through the rectus abdominis. Bleeding must be strictly controlled and cholecystectomy must be performed with great care. Before the operation, it is necessary to ensure that there is no evidence of pathology outside the gall-bladder; nevertheless the common bile duct must be checked during the operation. In the last ten years, this approach has been used in 125 patients (4.6% of cholecystectomies) with excellent results.