胆囊炎 - 囊性结扎

Cholecistitis - Cystic Ligation

发布时间：2013-07-06

Case description:
42 years old woman, right hipocondrium pain for 2 weeks. Ultrasound showed gallstone impacted on the infundibulum and signs of cholecistitis.

About the video: That's a non complicated cholecistitis surgery. I tried to edit the video the minimum possible, to demonstrate show that it is feasible to perform a ligature of the cystic duct using only 5mm working trocars. The scars of the working trocars were very small (that is showed at the end of the video).

Description of the surgery:
Laparoscopic cholecystectomy was indicated. Surgery was performed with 3 5mm trocars (1 epigastrium, 2x right hipocondrium) and 10mm (umbilicus for the optics). During the dissection (using hook and maryland) the gallstone was visualized on the infundibulum. After meticulous dissection, the cystic duct and artery were isolated, cystic artery and proper cystic artery were cauterized with monopolar hook. A retrograde dissection was performed, from the fundus to the infundibulum, after that the cystic duct was ligated with ethibond 2.0 (no 5mm clip applier was disponible at the time of the surgery), and after cutted, an additional endoloop was used on the cystic stump. After the section of the cystic duct and the release the gallbladder from the liver, the specimen was retrieved using a hand made extraction bag (glove).
At the end of the surgery,the gallbladder was examinated and is showed in the present video, one single gallstone was found.

Surgical Crew: Igor Teixeira Ferreira da SIlva / Clarisse / Rafael Bemuyal

Hospital Naval Marcílio Dias
Rio de Janeiro - Brasil
junho 2013