Hand-assisted laparoscopic surgery for complex gallstone disease: A report of five cases

Figure 3 Causes of hand-assisted laparoscopic surgery. A: One 1.0-cm stone impacted in the infundibulum fused with the CHD, impossible to remove with laparoscopic instruments; B: Using the intra-abdominal hand to facilitate such maneuvers as squeezing out of the stone (case 1); C: Compression of the CHD by one 2.5-cm stone; D: Identification and dissection of the obscured Calot triangle by the hand (case 4); E: A severely inflamed gallbladder with a neck stone caused obscured Calot’ triangle without jaundice (mimic Mirizzi syndrome, case 2).