Laparoscopic Management of an Adult Choledochal Cyst Using the E.K. Glove Port as Wound Protector for Extracorporeal Roux-en-Y Anastomosis and Optical Port.

Laparoscopic surgery has come to replace many conventional abdominal surgeries because of its outstanding advantages, including a better cosmetic result, faster recovery, and lesser postoperative pain. We present a case of laparoscopic-assisted total excision of Todani type I(B) choledochal cyst and biliary reconstruction in a 24-year-old female patient. Dissection of the cyst was done laparoscopically using the monopolar diathermy energy source. An end-to-side hepaticojejunostomy was created intracorporeally using 3-0 Vicryl suture, and end-to-side enteroenterostomy was completed outside the abdominal cavity using the E.K. glove port as wound protector. A new pair of gloves was then used to construct the glove port that served as the optical port. Additional instruments for retraction and suturing were deployed through the port whenever necessary. The use of the glove port also eliminated the need to suture the umbilical port before the completion of surgery. No intraoperative complications or technical problems were encountered using this technique. The use of the E.K. glove port makes it more a convenient and cost-effective procedure in a country like India.