Port placement for laparoscopic cholecystectomy*

An open (Hasson) technique is used to enter the peritoneal cavity and place a 5 to 12 mm Hasson trocar at the umbilicus. The laparoscope is introduced through this port, and three additional 5 mm ports are placed under direct vision 1 to 2 cm inferior to the right subcostal margin. The surgeon operates from the patient's left side using the subxiphoid and typically the medial subcostal port (shown in red). The assistant works from the patient's right side using the lateral subcostal port and periumbilical port (shown in blue).

The surgeon manipulates the infundibulum of the gallbladder to provide counter-retraction with the left hand and uses a dissector with the right hand through the subxiphoid port. The assistant uses the left hand to retract the fundus superiorly and operates the camera with the right hand. The gallbladder is usually removed through the umbilical port.