An Abnormal Fixation of Falciform Ligament Discovered Incidentally During Laparoscopic Cholecystectomy: A Factor of Difficult Laparoscopy.

Surgeons need to be aware of the clinical significance of congenital abnormalities and anomalies in the human body. The largest organ in the digestive system is the liver, which is supported by various peritoneal folds called ligaments. One of them is the falciform ligament, which holds the liver to the anterior abdominal wall and carries an obliterated umbilical vein. The abnormal falciform may cause acute surgical emergencies like intestinal obstruction or volvulus that increase morbidity and mortality. We report a case of a 24-year-old male patient who underwent laparoscopic cholecystectomy for symptomatic gallbladder stones. We encountered an aberrant falciform ligament attachment during the laparoscopy, complicating the creation of pneumoperitoneum. The aim of this case report is to make surgeons aware of abnormal attachment of the falciform ligament in the region of Veress needle insertion that can raise problems during the initial step of laparoscopy, that is pneumoperitoneum creation by a blind technique with the help of either the Veress or direct trocar insertion.