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LIVE UNCUT SURGERY: laparoscopic cholecystectomy for cholelithiasis, a gold standard procedure

D Mutter, MD, PhD, FACS G Philouze, MD B Seeliger, MD J Marescaux, MD, FACS, Hon FRCS, Hon FJSES, Hon FASA, Hon APSA
Epublication WebSurg.com, Dec 2018;18(12). URL: http://websurg.com/doi/vd01en5446

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  • 2018-12-18
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This video describes an "ideal" cholecystectomy, with a stepwise approach to the cystic pedicle and the dissection of the gallbladder. This video emphasizes the key points of dissection necessary to perform a safe cholecystectomy. The initial approach aims to expose the infundibulum and to successively dissect the anterior and posterior reflection of the peritoneum. It provides a safe view of the cystic duct and the cystic artery which can be dissected in order to secure the “critical view of safety”, exposing the cystic artery clearly away from the common bile duct and the right hepatic artery. This highlights the risky parts of the dissection when rules are not respected. After complete control of the pedicle, freeing of the gallbladder in the appropriate plane avoids any oozing, keeping the operative field totally clear and safe. Finally, the video shows the extraction method for the gallbladder, allowing the procedure to be performed with three 5mm ports and one 10-12mm port, thereby limiting the risk of postoperative port-site hernia. This 20-minute live uncut video is a demonstration of a gold standard procedure.