Introduction : Laparoscopic surgery for IHD stones is known to be difficult. With the development of surgical instruments, laparoscopic surgery has become a safe and effective procedure for IHD stones. The solo single surgery using a laparoscopic scope holder shows the highly cosmetic effect and we expect it to cause less pain. We described the solo single incision major hepatectomy for IHD stones.

Methods : A 3.0cm sized single incision through the umbilicus was made. A 10mm flexible laparoscopic camera was inserted through a glove port and fixed using a jaw of a camera holder. After the division of cystic duct and cystic artery, the gallbladder and round ligament were fixed to the abdominal wall using endo-grip. Left hepatic artery and portal vein were ligated, then demarcation line was drawn for the anterior approach. The left bile duct was dissected and ligated. During parenchymal dissection, the right anterior glissonean pedicle was dissected and transected using the Endo-stapler. After complete dissection of the left liver, the middle and left hepatic vein were ligated using the Endo-stapler.

Results : This operation took 220 minutes and the estimated blood loss was 150mL.

Conclusions : Laparoscopic surgery had become a safe and feasible procedure for IHD stones. The solo surgery under a single incision can be a new option in laparoscopic hepatectomy for IHD stones.