This procedure involves a cholecystectomy via mini


:point_right:This procedure involves a cholecystectomy via mini-
laparotomy through a cylindrical retractor that is 3.8 cm in diameter and 10 cm in length even in local anaesthesia or sedation.
:point_right:Occasionally, a cylinder of 5 cm in diameter or 12 cm in length is used when difficul-
ties are anticipated or encountered during surgery with the 3.8-cm cylinder.
:point_right:A uniform 4.5-cm right transversal-epigastric incision was made. Rectus muscle fibres were split, not sectioned. Cylinder has a methacrylate embolus, which allows for visual insertion and binocular inspection of the abdominal cavity
:point_right:The procedure is performed with conventional reusable open surgery instruments, with the exception of a disposable Direct Drive® clip applier.

This technique can be done under Local anaesthesia/sedation in 75% of selected patients for “AMBULATORYSURGERY”.
:point_right:The technique is safe efficient with low complication rate & untroubled convalescence
:point_right:Male sex,BMI,gallbladder wall thickness, and a history of acute cholecystitis are factors that increase the probability of conversion to General anesthesia.