Railroading removal of gall bladder in laparoscopic cholecystectomy

Laparoscopic cholecystectomy can be performed using instruments even smaller than 3 mm in diameter and with two, three or four ports, depending on the choice of the operating surgeon. In any of these techniques of laparoscopic cholecystectomy, the gall bladder is usually removed through the umbilical port. This requires repositioning of the instruments and reorientation. Using the standard four port technique, the gall bladder was removed in 772 cases of laparoscopic cholecystectomy, through the umbilical port, without changing the position or the size of instruments, using the modification described below. A tense and distended gall bladder was decompressed prior to removal and the fascial opening was enlarged for a large gall bladder or with a large stone. It is a safe, quick and efficient way of removing the gall bladder after laparoscopic cholecystectomy.