Figure 2: Standard trocar locations for a laparopscopic cholecystectomy include supraumbilical, subxiphoid, medial right subcostal, and lateral subcostal sites (A) and modified trocar placement relative to driveline locations for patients with left ventricular assist device (B), biventricular assist device (C), and total artificial hearts (D) undergoing laparoscopic cholecystectomy. Initial trocar placement was via supraumbilical for LVAD and TAH and infraumbilical for BiVAD. The subxiphoid trocar site was placed more caudally to avoid LVAD and BiVAD drivelines and more caudally and more rightward to avoid TAH drivelines. Avoidance of the BiVAD drivelines also required shifting all trocar sites caudally.