Abstract
Background: After considerable experience with laparoscopic cholecystectomy (LC) using four ports, Authors began the three‐port LC. Opioid free anesthesia OFA means a technique in which no intraoperative opioid is administered through any route.
Objectives: Study aims to assess both of the safety while using 3 ports during the laparoscopic cholecystectomy procedures and the efficiency of the Opioid Free Anesthesia throughout the perioperative period.  
Patients and Methods: Patients were scheduled for elective laparoscopic cholecystectomy and classified randomly into two groups, each one contained 25 patients. Group one has submitted for Opioid Based Anesthesia protocol and group two has submitted to Opioid Free Anesthesia protocol. Surgical technique was Laparoscopic cholecystectomy and it was first tried by 3 port then the fourth port is inserted when indicated.   
Results: Three‐port LC successfully performed in 92% of cases of the study with safety.  There were a statistically significant decrease in perioperative HR, and MAP. Study showed decrease in VAS score, post-operative Pethidine consumption and PONV. No major postoperative complications, as bile leakage or bleeding have been reported.
Conclusion: Three‐port LC is a safe and technically feasible. Also OFA is superior to (OA) in anesthesia of patients undergoing LC.