Isolated Arterial Injury of Moynihan's Hump During Laparoscopic Cholecystectomy: A Case Report With Video

Isolated arterial injury of major vessels during laparoscopic cholecystectomy is a rare complication, most commonly involving the right hepatic artery (RHA). Moynihan's hump (also known as "caterpillar hump") is a rare but significant anatomical variant that represents a major predisposing factor for iatrogenic vascular injuries during cholecystectomy. In this variant, the RHA follows a tortuous, U-shaped course within the hepatocystic triangle. This configuration often results in a short cystic artery, making the RHA itself highly vulnerable to accidental clipping or transection. This case report demonstrates an isolated intraoperative injury to the RHA during laparoscopic cholecystectomy and its subsequent management. We discuss management strategies for arterial injury and preventive measures to avoid such complications. Awareness of arterial variations in the hepatocystic triangle, along with routine implementation and proper understanding of the critical view of safety, could significantly reduce iatrogenic injuries during laparoscopic cholecystectomy. Knowing bailout strategies in laparoscopic cholecystectomy is crucial. The decision whether to reconstruct the RHA should be made on an individual, case-by-case basis.