Difficult Laparoscopic Cholecystectomy Performed by Pledget Dissection of Calot's Triangle

This video demonstrates Difficult Laparoscopic Cholecystectomy with Pledget and Mishra's Knot. Laparoscopic cholecystectomy is the treatment of choice for gallbladder stone disease. Difficult laparoscopic cholecystectomy is associated with serious complications and a high conversion rate. The aim of this video is to show the video of difficult laparoscopic cholecystectomy to give information about the current strategies to manage difficult cholecystectomy. No consensus is found among laparoscopic surgeons on how to manage difficult laparoscopic cholecystectomy. Iatrogenic injuries and conversion rate can be reduced depending on the surgeon's experience, special techniques, and intraoperative investigations, and using blunt dissection with the help of pledget and tying an extracorporeal knot. Subtotal cholecystectomy, antegrade or fundus first techniques and intra-operative cholangiogram using ICG can significantly reduce the complications and conversion rate of laparoscopic cholecystectomy.