Avoiding port site bleeding in laparoscopic cholecystectomy

Haemorrhage from laparoscopic port sites is uncommon but potentially significant. In laparoscopic cholecystectomy, three incisions are made beyond the umbilicus. Bleeding is usually associated with insertion of the most lateral port. This port is typically inserted under direct vision with overhead lights turned off. If the light source is pressed firmly against the lateral abdominal wall from the inside to illuminate the area of intended port insertion on the outside, the major subcutaneous vessels can be visualised and therefore avoided. This simple technique dramatically reduces the chance of port site bleeding and is applicable to other laparoscopic abdominal procedures.