A Safe Simple Method for Removal of the Gallbladder Through the Umbilical Trocar Site During Laparoscopic Cholecystectomy

Abstract
After laparoscopic resection, the gallbladder must be removed, usually through the umbilical trocar site. Occasionally, there is difficulty in removing the gallbladder from the abdominal cavity due to its large dimensions or its contents. There are two main options to extract the gallbladder in such cases. One is evacuation of its content through the gallbladder neck protruding from the abdominal wall. The second is extension of the periumbilical fascial opening.1–5 In the first method, gallbladder content might sometimes spill into the peritoneal cavity or contaminate the incision site. In the second, there might not be enough control concerning the extent of injury caused to the periumbilical abdominal wall during enlargement of the fascial opening. A simple precise and safe method is suggested to enlarge the fascial incision by direct vision using transillumination.

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