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Laparoscopic Cholecystectomy with Indocyanine Green Fluorescence: Choledochoscopic Stone Extraction and Primary Duct Suture
Published on: November 25, 2025
Covert laparoscopic cholecystectomy:a new minimally invasive technique.
Hai Hu1, Jiang Fan Zhu, An Hua Huang
1Department of Minimally Invasive Surgery, Tongji University Affiliated Shanghai East Hospital, PR China. huhailc@sina.com
Acta Medica Okayama
|November 1, 2011
Summary
A new completely covert laparoscopic cholecystectomy (LC) approach improves transumbilical endoscopic surgery (TUES) outcomes. This technique offers excellent cosmetic results with hidden incisions and no need for postoperative analgesia.
Area of Science:
- Minimally Invasive Surgery
- Surgical Oncology
- Gastrointestinal Surgery
Background:
- Transumbilical endoscopic surgery (TUES) aims to reduce visible scarring.
- Existing TUES techniques can face challenges with instrument interference and triangulation.
- Further refinement is needed for improved cosmetic outcomes and surgical efficiency.
Purpose of the Study:
- To develop and evaluate a completely covert laparoscopic cholecystectomy (LC) technique.
- To overcome limitations of previous transumbilical endoscopic surgery (TUES) approaches.
- To assess the safety, efficacy, and cosmetic results of the novel method.
Main Methods:
- A prospective study involving twelve patients undergoing laparoscopic cholecystectomy (LC).
- A 10-mm umbilical trocar for laparoscope insertion and two 5-mm suprapubic trocars for instruments.
- Laparoscope repositioning to a suprapubic trocar to optimize triangulation and instrument access.
Main Results:
- All twelve gallbladder removals were completed successfully without intraoperative complications.
- Mean operative time was 28.5 ± 5.7 minutes.
- Patients experienced rapid recovery, resuming oral intake within 6 hours and requiring no postoperative analgesia.
Conclusions:
- The developed covert laparoscopic cholecystectomy (LC) is a safe and effective approach.
- This technique provides superior cosmetic results by completely hiding incisions.
- It overcomes previous transumbilical endoscopic surgery (TUES) limitations, offering a simpler and more aesthetically pleasing alternative.