IntroductionBilateral external carotid arteries ligation is a rare practice in cases of extensive maxilla-facial injuries. Defining indication criteria in the management of such cases is highly demanded in emergency surgery.Case presentationReported case presents a male patient 67 years old man with a gunshot to the face. The whole face was macerated. Patient was operated surgically performing bilateral external carotid artery ligation, tracheostomy, pharyngostomy, gastrostomy and pressure dressing to face and head.ConclusionThe procedure of bilateral external carotid artery ligation has no defined role in the management of maxillofacial trauma. The current status of such procedure in maxillofacial trauma needs revision.

The study has offered a novel anatomical concept and safe surgical technique avoiding exploration of Calot's triangle. The new concept has minimized dissection demands and risk of injury related to the traditional laparoscopic cholecystectomy. The study has proposed a potentially secure and empirical laparoscopic cholecystectomy technique that could be considered in every case.

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The new technique provides safe tube introduction and precise tube positioning, saves time, and involves no technical precautions. The technique has been applied on selected simple cases as the first trial and requires further testing in cases of hemothorax, empyema thoracis, traumatic chest injuries, and complicated pulmonary diseases that require drainage. Further evaluation of the technique by randomized studies is required.