LAPAROSCOPIC PARTIAL CHOLECYSTECTOMY FROM THE FUNDUS DOWNWARD USING ACOMBINATION OF PNEUMOPERITONEUM AND THE ABDOMINAL WALL-LIFT METHOD INCOMPLICATED CHOLELITHIASIS

To safely and reliably perform laparoscopic cholecystectomy in complic ated cholelithiasis, we designed a method of initially resecting the a nterior wail of the fundus and body from the fundus downward, fully di ssecting the neck of the gall bladder from the liver bed, and finally dissecting the cystic duct and artery. This method differs from routin e laparoscopic cholecystectomy in that the cystic duct is dissected fi rst, and cholecystectomy is performed from the neck upward. In additio n, to preventing inadequacy of the operative field, because of repeate d suction, both the pneumoperitoneum and an abdominal wall-lift method are utilized. Our operation procedure makes it possible to perform co mplicated cholelithiasis safely during laparoscopic surgery.