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Case Report | Surgery | Volume 15 Issue 7, July 2026 | Pages: 1726 - 1735 | India
Sequential Camera Exchange Technique (SCET) in Modified Three-Port Laparoscopic Cholecystectomy Using a Concealed Suprapubic Port: A Technical Report with Case Illustration
Abstract: Background: Laparoscopic cholecystectomy is the gold standard treatment for symptomatic gallstone disease. Although the conventional four-port technique remains widely practiced, ongoing efforts to further reduce surgical trauma and improve cosmetic outcomes have led to the development of various reduced-port approaches. However, many of these techniques compromise instrument ergonomics or require advanced laparoscopic expertise. We describe a modified three-port laparoscopic cholecystectomy utilizing a concealed suprapubic working port and a low right iliac working port that preserves triangulation while minimizing visible abdominal scars. Case Presentation: A 21-year-old female (BMI 16.2 kg/m?) presented with intermittent right upper abdominal pain for one year. Ultrasonography demonstrated multiple gallbladder calculi measuring approximately 4.7 mm with posterior acoustic shadowing, while the gallbladder wall and common bile duct were normal. Routine laboratory investigations were within normal limits. A modified three-port laparoscopic cholecystectomy incorporating a Sequential Camera Exchange Technique (SCET) was performed using two 5-mm ports and one concealed 10-mm suprapubic port. The procedure was completed successfully in 72 minutes with an estimated blood loss of 20 mL. The Critical View of Safety was achieved without the need for additional ports or conversion to open surgery. Postoperative recovery was uneventful, with Visual Analogue Scale (VAS) pain scores of 4 at 6 hours and 2 on postoperative day one, and the patient was discharged on postoperative day one with excellent cosmetic satisfaction. Conclusion: This modified three-port laparoscopic cholecystectomy technique appears to be a safe, feasible, and cosmetically favorable alternative to the conventional four-port approach in carefully selected patients. By relocating the principal working port to the concealed suprapubic region while maintaining a low right iliac working port, the technique preserves operative ergonomics, facilitates safe dissection of Calot's triangle, and achieves excellent cosmetic results. Larger prospective comparative studies are required to evaluate its reproducibility, safety, and long-term clinical outcomes.
Keywords: Cholecystectomy, Laparoscopic, Cholelithiasis, Minimally Invasive Surgical Procedures, Reduced-Port Surgery, Suprapubic Port, Cosmetic Outcome, Surgical Innovation, Three-Port Laparoscopy
How to Cite?: Dr. Sanjay Kala, Dr. Shashank Khandelwal, Dr. Durgesh Tiwari, "Sequential Camera Exchange Technique (SCET) in Modified Three-Port Laparoscopic Cholecystectomy Using a Concealed Suprapubic Port: A Technical Report with Case Illustration", Volume 15 Issue 7, July 2026, International Journal of Science and Research (IJSR), Pages: 1726-1735, https://www.ijsr.net/getabstract.php?paperid=SR26720221257, DOI: https://dx.doi.org/10.21275/SR26720221257