Cholecystectomy iOS application

laparoscopictrainingsimulation

Background Laparoscopic Cholecystectomy is the standard of care for patients requiring removal of gall bladder. It involves removal of gall bladder via a minimally invasive technique, and can be performed as a day case in most cases. It is one of the most common surgical procedures performed today. Laparoscopic Cholecystectomy is considered by many to be a routine and simple procedure, but can lead to debilitating complications and even mortality if certain principles are not adhered to by the surgical team. Even today, more than 30 years after its acceptance, the bile duct injury rate in laparoscopic cholecystectomy remain higher than open cholecystectomy. A meticulous pre-operative workup and high index of suspicion during the procedure should be maintained by the surgeon. This module will take you through various steps of the procedure and we have tried our best to include the smallest of detail required. Key anatomy The calot’s triangle is formed by common hepatic duct, cystic artery and cystic duct. It contains a lymph node along with connective tissue. To safely dissect calot’s triangle is the main challenge in cholecystectomy. The surgeon should remain close to the gall bladder and avoid dissecting toward the common duct. A critical view of safety should be achieved before clipping any structure. There are three criteria to achieve critical view of safety: • The hepatocystic triangle is cleared of fat and fibrous tissue. The hepatocystic triangle is defined as the triangle formed by the cystic duct, the common hepatic duct, and inferior edge of the liver. The common bile duct and common hepatic duct do not have to be exposed.