Procedure:
- To begin the operation, the patient is placed in the supine position on the operating table and anesthetized.
- Disinfect the skin of patient using antiseptic lotion like savlon,betadin,spirit.
- Maintain the sterile technique during procedure.
- A scalpel is used to make a small incision at the umbilicus
- Using either a Veress needle or Hasson technique the abdominal cavity is entered.
- The surgeon inflates the abdominal cavity with carbon dioxide to create a working space.
- The camera is placed through the umbilical port and the abdominal cavity is inspected.
- Additional ports are opened inferior to the ribs at the epigastric, midclavicular, and anterior axillary positions.
- The gallbladder fundus is identified, grasped, and retracted superiorly.
- With a second grasper, the gallbladder infundibulum is retracted laterally to expose and open Calot's Triangle (the area bound by the cystic artery, cystic duct, and common hepatic duct).
- The triangle is gently dissected to clear the peritoneal covering and obtain a view of the underlying structures.
- The cystic duct and the cystic artery are identified, clipped with tiny titanium clips and cut.
- Then the gallbladder is dissected away from the liver bed and removed through one of the ports
Recently, this procedure is performed through a single incision in the patient's umbilicus. This advanced technique is called Laparoendoscopic Single Site Surgery or "LESS".
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