Hasson Versus Veress Access With Umbilical Versus Epigastric Gallbladder Extraction in Laparoscopic Cholecystectomy

This single-centre randomised pilot study compared two strategies for primary abdominal access and gallbladder extraction in elective laparoscopic cholecystectomy: open (Hasson) umbilical access with extraction of the gallbladder through the umbilical incision, and closed (Veress needle) access with extraction through the epigastric port. Access time, gallbladder extraction time, total operative time and postoperative pain were compared. Enrolment was stopped in March 2020 when elective laparoscopic surgery was suspended because of the COVID-19 pandemic. This trial was registered retrospectively

Inclusion Criteria: Symptomatic cholelithiasis scheduled for elective laparoscopic cholecystectomy Age 18-70 years Body mass index ≤30 kg/m² Exclusion Criteria: Previous midline abdominal surgery Acute cholecystitis or a history of acute cholecystitis Conversion to open surgery, intraoperative gallbladder perforation or other intraoperative complication (excluded after randomisation)