A Case Report: Transumbilical Multiple-Port Laparoscopic Cholecystectomy in Patients with Severe Senile Kyphoscoliosis

Abstract

The patient was a 78 year-old woman who had gallbladder stones and gall bladder polyp.
She had severe senile kyphoscoliosis and it was difficult to extend the spine under general anesthesia.
Laparoscopic cholecystectomy was undertaken with transumbilical multi-port device. The first laparoscopic view revealed a small working space caused by a low-lying costal arch. The ligamentum teres was lifted to the abdominal wall after sutureing. An assist port was inserted under the costal arch. We hold the fundus of gallbladder and lifted the gallbladder and the low-costal arch with straight grasping forceps. The working space was restricted, but we obtained a workable surgical field. We could keep the co-axial setting and achieve the laparoscopic cholecystectomy with transumbilical multi-port. Transumbilical multi-port is useful for endoscopic procedure in small working space.