Three-port laparoscopic cholecystectomy by harmonic dissection without cystic duct and artery clipping

Background: The technique of laparoscopic cholecystectomy (LC) still has areas of refinements. To decrease the number of ports, a cannula may be replaced by a percutaneous suture suspension of the gallbladder. The risk of tissue injury caused by repeat blind extraction and insertion of various instruments in and out of the abdomen may be decreased by the use of the multipurpose harmonic dissector. Methods: One hundred consecutive patients with symptomatic cholelithiasis underwent 3-port LC entirely performed by harmonic dissector without cystic duct and artery clipping. Results: In 8 cases, a fourth trocar was necessary. In 2 cases, the cystic duct was clipped after an unsafe ultrasound sealing. In 1 case, continuous bleeding from the liver required the use of diathermy. No common bile duct injury was registered. Conclusions: The 3-port harmonic LC is a feasible, effective, and safe technique. (c) 2006 Excerpta Medica Inc. All rights reserved.