Before the fundus is disconnected, and while upward traction is still in place, the gallbladder bed and cystic pedicle stumps are checked for bleeding and bile leak. Gallbladder bed bleeders are carefully and lightly touched with the flat of the spatula so as not to burn deeply into the liver and compound the problem. Application of hemostatic sponge may be used for diffuse ooze. The field is irrigated and suctioned.
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The final attachment of the gallbladder is divided. The gallbladder is removed through the umbilical or epigastric port. The umbilical port, especially with the Hasson technique, is easiest to enlarge and repair if necessary. If the umbilical port is used, the camera is shifted to the epigastric port. Image reversal may make manipulation difficult.
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