Hand-assisted laparoscopic cholecystectomy at cesarean section.

Laparoscopic cholecystectomy at the time of elective cesarean delivery eliminates the need for separate operations. Hand-assisted laparoscopy takes technical advantage of the cesarean abdominal incision to facilitate laparoscopic maneuvers with retention of pneumoperitoneum. A 39-year-old woman with two previous cesarean sections and recurrent cholecystitis throughout her third pregnancy underwent full-term, elective cesarean section, tubal sterilization, and hand-assisted laparoscopic cholecystectomy under general anesthesia. Total operating time was 53 minutes, estimated blood loss was 550 ml, and postoperative hospital stay was 72 hours. The operation and recovery were uneventful.