Ace the 2025 Fundamentals of Endoscopic Surgery (FES) Exam – Slice Through with Surgical Precision!

The trocar utilized for introducing a choledochoscope is typically positioned at the medial subcostal port. This approach offers a more direct access route to the common bile duct and the surrounding anatomy, which is essential for the procedures involving the choledochoscope. The choice of the medial subcostal port allows for better visualization and maneuverability within the upper abdominal cavity, reducing the risk of injury to adjacent structures during the insertion of the choledochoscope.

Taking into account anatomical considerations, positioning the trocar at the medial subcostal site minimizes interference with the liver and gallbladder and optimally aligns with the pathways used during procedures like endoscopic retrograde cholangiopancreatography (ERCP) and stone retrieval procedures. This positioning aids in effective viewing of the biliary tree and helps surgeons perform tasks such as removing stones or visualizing strictures more efficiently.

While other ports like the right upper quadrant and umbilical port may be useful for various laparoscopic procedures, they do not provide the same advantageous direct access for the choledochoscope as the medial subcostal port does. This distinction highlights the importance of choosing the correct port based on the specific endoscopic procedure being performed.