Preoperative preparation and anesthesia were the
same as for conventional laparoscopic cholecystectomy.
A 1.5 cm arc-incision was made along the lower
side of the umbilicus. A simple method was used to
establish an operation channel and maintain pneumoperitoneum.
We cut down a part of the long arm
from a T-tube and circled it to a ring. The diameter of
the ring was about 3.0 cm. The glove wrist was
wrapped up to the tube ring, which was put into
the peritoneal cavity through the umbilical incision
(Figure 1). The tips of the glove fingers were opened,
from which three trocars (one 10 mm and two 5 mm)
were put in and ligated (Figure 2). The incision was
sealed by the glove, which avoided air leakage. The
5-mm laparoscope and laparoscopic instruments were
inserted into the peritoneal cavity through the glove
finger trocars (Figure 3). The adhesion around the
gallbladder was dissected. We retracted the fundus of
the gallbladder and exposed the anatomy of Calot
triangle adequately by two 5 mm laparoscopic graspers
via the 10 mm and 5 mm tcocar. The cystic duct
and artery were clearly identified and separated by the
5 mm electric hook and grasper, then clipped by
titanium clips via the 10 mm tcocar and cut. The
gallbladder was pulled upward or downward to
expose the gallbladder bed and removed from the