Bile is extracted directly from the bear’s gall bladder by means of a temporary catheter and pump or a syringe. After the bear has been drugged with ketamine, its gall bladder is located (by means of an ultrasound or by repeated “blindpuncturing” attempts with a needle) and the bile is extracted using a catheter and pump or a syringe. Around 80–100ml of bile is extracted from each bear each time.

This method is common in Vietnam.