Entry into the peritoneal cavity can be gained through the left upper quadrant or via a supraumbilical port (shown in red in the figure).
- For left upper quadrant access, a Veress needle is inserted. Gastric decompression with an orogastric tube prior to needle insertion minimizes the risk of gastric perforation. The needle should be angled approximately 15 degrees caudad to minimize the risk of splenic injury.
- Placement of a supraumbilical port 6 cm above the fundus with a Hasson technique is another entry method that reduces the risk of organ perforation.
Additional ports required for performing laparoscopic cholecystectomy include two 5 mm ports in the right upper quadrant and an 11 mm port in the epigastrium (shown in black in the figure).
