To evaluate the safety and efficacy of scar-hidden laparoscopic cholecystectomy (LC) via umbilical bracket-like approach using conventional instruments.

Clinical data of 10 patients undergoing LC in the Seventh Affiliated Hospital of Sun Yat-sen University from June to October 2019 were retrospectively analyzed. Among them, 3 patients were male and 7 female, aged from 27 to 55 years with a median of 42 years. The informed consents of all patients were obtained and the local ethical committee approval was received. A 10-mm Trocar was inserted through a bracket-like incision of both sides of umbilical. The operation and observation instruments were inserted. A Minilap needle was inserted under the right costal margin, and the gallbladder bottom was sutured to the right superior costal region using purse-string suture to enlarge the exposure. LC were completed. The surgical status and postoperative complications were observed.

All patients completed LC successfully. No patient was converted to open surgery. The left observation port and the right operation port significantly reduced the "chopstick effect" of single incision LC. Minilap + suture lifting technique could fully expose the surgical field and provide sufficient tension. The median operation time was 45(30-75) min. Intraoperative blood loss was 5(3-20) ml. The postoperative pain score was 1(0-2). The length of postoperative hospital stay was 2(1-3) d. No LC-induced complications occurred. Reexamination at postoperative 2 weeks found that the umbilical bracket-like incision healed well and the scar was invisible. The satisfaction rate of patients was 100%.

Compared with the conventional single-port LC, scar-hidden LC via umbilical bracket-like approach using conventional instruments has advantages such as micro invasiveness, better appearance, better convenience and lower cost, which is applicable for treating most benign gallbladder diseases.