Kang LM, Zhao YH, Yu FK, Zhang FW, Kang X. Two-point lifting/retracting technology for transumbilical single-port laparoscopic cholecystectomy based on the anatomical features of Calot's triangle. World J Gastrointest Surg 2025; 17(7): 104261 [DOI: 10.4240/wjgs.v17.i7.104261]
Corresponding Author of This Article
Li-Min Kang, MD, PhD, Department of Hepatobiliary and Pancreatic Surgery, Puer People’s Hospital, No. 44 Zhenxing Street, Puer 665000, Yunnan Province, China. kanglimin2010@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jul 27, 2025; 17(7): 104261 Published online Jul 27, 2025. doi: 10.4240/wjgs.v17.i7.104261
Two-point lifting/retracting technology for transumbilical single-port laparoscopic cholecystectomy based on the anatomical features of Calot's triangle
Li-Min Kang, Ying-Hong Zhao, Fa-Kun Yu, Fu-Wei Zhang, Xin Kang
Li-Min Kang, Ying-Hong Zhao, Fa-Kun Yu, Fu-Wei Zhang, Department of Hepatobiliary and Pancreatic Surgery, Puer People’s Hospital, Puer 665000, Yunnan Province, China
Xin Kang, Department of Emergency Medicine, The Fifth Affiliated Hospital, Southern Medical University, Guangzhou 510999, Guangdong Province, China
Co-corresponding authors: Li-Min Kang and Xin Kang.
Author contributions: Kang LM and Kang X contribute equally to this stud as co-corresponding authors; Kang LM, Zhao YH, Xu L, Yu FK, and Zhang FW completion of surgeries and collected the clinical data; Kang LM and Kang X analyzed the data and wrote the paper; all authors have read and approved the final version.
Institutional review board statement: The study was received and approval by the Institutional review board of Puer People's Hospital (Approval Number: 2023-001-05).
Informed consent statement: The informed consent was obtained from all patients.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: The data that support the findings of this study are available on request from the corresponding author.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Min Kang, MD, PhD, Department of Hepatobiliary and Pancreatic Surgery, Puer People’s Hospital, No. 44 Zhenxing Street, Puer 665000, Yunnan Province, China. kanglimin2010@163.com
Received: December 16, 2024 Revised: March 26, 2025 Accepted: May 21, 2025 Published online: July 27, 2025 Processing time: 220 Days and 6.1 Hours
Abstract
BACKGROUND
Among the rapidly developing single-incision laparoscopic cholecystectomy (LC) techniques, transumbilical single-incision LC is increasingly replacing the traditional LC, with advantages of minimal invasion, slight postoperative pain, faster recovery. Despite the advantages mentioned above, the currently available specialized single-port laparoscopic instruments are hindered by high costs and limited applications, challenging their widespread use in medical facilities.
AIM
To design a two-point lifting/retracting (TPLR) technique for transumbilical single-port LC (TUSPLC) based on the anatomical features of the Calot's triangle (or cystohepatic triangle) and investigate its surgical feasibility.
METHODS
The clinical data of 103 patients who underwent TUSPLC utilizing the TPLR technique in the Department of Hepatobiliary Surgery at our hospital between June 2023 and June 2024 were retrospectively analyzed. The patient cohort included 82 cases of cholelithiasis, 11 cases of gallbladder polyps, 6 cases of concurrent gallstones and polyps, and 4 cases of gallbladder adenomyomatosis.
RESULTS
All the surgical procedures were conducted using standard laparoscopic instruments. Surgery was successful in 98 (95.14%) patients using the TPLR method, which effectively exposed the Calot's triangle during surgery. The operative time ranged from 35 to 70 minutes, with an average of 42.4 ± 26.8 minutes. In 3 cases, an additional operative port was required below the xiphoid process, and 2 cases were converted to conventional three-port LC. No complications such as abdominal pain, fever, bile leakage, hemorrhage, or incisional infection were noted postoperatively. No discernible surgical scars were observed at the 2-week postoperative reexamination. Additionally, a 3-month follow-up period revealed no complications.
CONCLUSION
The TPLR technique, developed based on the anatomical features of the Calot's triangle, facilitates exposure of the Calot's triangle during surgery. It is a simple, safe, feasible, and cost-effective method, and a promising approach for single-port LC.
Core Tip: Our team design a two-point lifting/retracting (TPLR) technique for transumbilical single-port laparoscopic cholecystectomy (LC) based on the anatomical features of the Calot's triangle (or cystohepatic triangle). All the surgical procedures were conducted using standard laparoscopic instruments. Surgery was successful in 98 (95.14%) patients using the TPLR method, which effectively exposed the Calot's triangle during surgery. The TPLR technique is a simple, safe, feasible, and cost-effective method, and a promising approach for single-port LC.
