Micro-instrumentation for minimally invasive cholecystectomy: surgical technique
Epublication WebSurg.com, Oct 2007;07(10). URL: http://websurg.com/doi/vd01en2146
This video demonstrates an esthetic cholecystectomy using 2mm micro-instruments. The key steps and difficulties of this procedure are shown in detail by Professor Didier Mutter. This video is recommended to general surgeons. The authors use 2mm micro-instruments in this 25-year-old woman with symptomatic cholelithiasis. They dissect in the avascular plane between Glisson’s capsule and the gallbladder. Dissection with the micro-instruments is more time-consuming than with conventional instruments because the 2mm instruments have two drawbacks: flexibility, and being situated inside the abdomen with little of the instrument on the outside. After the dissection, the authors remove the 2 cameras and introduce the extraction bag through the umbilicus. They then reinsert the 10mm camera to check the operative field and help guide removal of the trocars. This step helps to minimize postoperative hemorrhage. Cosmesis is enhanced with three 2mm incisions and one 10mm incision deep in the umbilicus.