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Laparoscopic Cholecystectomy with Indocyanine Green Fluorescence: Choledochoscopic Stone Extraction and Primary Duct Suture
Published on: November 25, 2025
Totally transumbilical endoscopic cholecystectomy without visible abdominal scar using improved instruments
Jiang Fan Zhu1, Hai Hu, Ying Zhang Ma
1Department of General Surgery, East Hospital of Tongji University, 150 Ji Mo Road, 200120, Pudong, Shanghai, China. zhujiangfan@hotmail.com
Surgical Endoscopy
|December 11, 2008
Summary
This study introduces improved instruments for totally transumbilical endoscopic cholecystectomy, overcoming the challenge of instrument interference. The technique proved feasible, enabling successful gallbladder removal with excellent cosmetic outcomes.
Area of Science:
- Minimally Invasive Surgery
- Surgical Instrumentation
- Gastrointestinal Endoscopy
Background:
- Transumbilical endoscopic surgery faces challenges due to external instrument interference around the umbilicus.
- This interference can limit the feasibility and safety of procedures like cholecystectomy.
Purpose of the Study:
- To describe a technique for totally transumbilical endoscopic cholecystectomy (TUEC).
- To introduce improved instruments designed to mitigate external interference during TUEC.
Main Methods:
- Development of new 5 mm and 3 mm trocars with reduced diameters (8 mm and 5 mm).
- Utilization of instruments extended by 5 cm compared to standard commercial options.
- Successful execution of ten TUEC procedures.
Main Results:
- All ten gallbladders were successfully removed, with one instance of cautery-induced perforation.
- Average operative time was 62 ± 25 minutes.
- Patients reported high satisfaction with cosmetic results, early discharge (48 hours), and rapid return to work (within 7 days).
Conclusions:
- Improved instruments partially overcome trocar and instrument interference in TUEC.
- The described technique makes totally transumbilical endoscopic cholecystectomy a feasible surgical option.
