Control of port-site bleeding from smaller incisions after laparoscopic cholecystectomy surgery: a new, innovative,...

Laparoscopic cholecystectomy has become the standard of care for patients with acute cholecystitis, symptomatic cholelithiasis, and biliary dyskinesia. Most surgeons now perform this procedure as outpatient surgery. In a standard laparoscopic cholecystectomy procedure, three trocar incisions are made outside the umbilicus. Stopping the bleeding from these port sites can be problematic because of the small size of the incision and the fact that these bleeding points are situated deep in the incision. This is especially true in obese patients and patients taking Asprin or Plavix and undergoing emergency cholecystectomy. In these circumstances, control of the bleeding requires either enlargement of the incision or placement of deep sutures, leading to an ugly scar. We present a simple and innovative technique for controlling port-site bleeding, which involves plugging the port-site hole with Surgicel (Johnson & Johnson Medical, Inc., Arlington, Texas). Our experience with 20 patients to date has shown wound healing to be excellent, with no complications such as hematoma or infection.