择期胆囊切除术-体重指数46 63MB

Eletive Cholecystectomy - BMI 46 - Why Start From the Fundus-

In this video i try to show how important is to release the fundus at the beginning of the cholecystectomy, to prevent liver injure (showed in the video) and provide better infundibulum exposure.
The Patient was a woman, 59 years, BMI of 46, with a single gallstone (more than 3cm in diameter), with history of ocasional pain in the abdominal upper right quadrant. Eletive cholecystectomy was performed. At first, after tried to dissect the infundibulum, due to excessive traction on the fundus, a small lesion of the hepatic capsule was observed with some blood loss, after that, fundus release was performed, and a better exposure of the infundibulum was achived, with no risk to increase the hepatic lesion.

Surgical Crew: IgorTFerreira / Rafael Bemmuyal / Leonardo Valadão