A new technique for exposing Calot's triangle during laparoscopic surgery: usefulness of extracorporeal lifting of the round ligament and gallbladder.

We developed a maneuver for holding and lifting the intraperitoneal organs from the extracorporeal side using a new instrument, the leading bar, by which we could guide the tape or the thread to the outside of the abdomen. In the case of cholecystolithiasis with a thickened wall or a stone stuck in the neck, we lifted the round ligament and gallbladder for better exposure of Calot's triangle, using the tape or thread through the abdominal wall to the extracorporeal side, and then clamped them with Kocher's forceps. With this technique, a good view of Calot's triangle was maintained so that the surgeon could expose the cystic duct easily and safely using both hands.