Critical View Of Safety - What To Do When Not Achieved - Step By Step Surgery - Safe Cholecystectomy
Creating a Culture of safety in cholecystectomy is the most important aim of surgical education as laparoscopic cholecystectomy is one of the most commonly performed procedures in surgical practice.
The performance of a safe cholecystectomy and avoidance of bile duct injuries is the key part of this educational video. We highlight here the strategies for safe dissection of Calot's triangle and give you steps of attaining the critical view of safety.
For those of you who missed the previous simple laparoscopic cholecystectomy video, We would RECOMMEND watching the video first as it will give you the basic steps.
You can watch it here: https://youtu.be/wl5-vgD6MNU
In the current video, we start with the preoperative considerations in difficult cases and then proceed on to give an answer to the most commonly asked question in all seminars and that is how to do a safe cholecystectomy.
The key points that you can see as per the video timeline are
Port placement for laparoscopic cholecystectomy (02:28)
Tips and tricks
For gall bladder retraction (03:55)
Absent Rouvier sulcus - Identifying landmarks (06:22)
Frozen Calot's triangle - no critical view of safety (17:15)
Fundus first cholecystectomy - Bailout strategy 1 (19:52)
The decision for subtotal cholecystectomy - Bailout strategy 2 (23:29)
Laparoscopic suturing for reconstituting cholecystectomy (27:29)
Most important Bailout strategy (29:55)
The video is surely not the only way to manage difficult cases and these are just a few tips and tricks to approach the atypical patient during surgery. It is an attempt to promote the SAGES safe cholecystectomy program and thereby spread awareness on the same.
THE KEY IS TO PREVENT BILIARY INJURIES.
One key point that We wish to highlight here is the USE OF INTRAOPERATIVE CHOLANGIOGRAPHY It is very beneficial in these cases and WE RECOMMEND IT TOO.
In the current case, we did not use it because we had preoperative MRCP as well as ERCP and we were quite certain of the anatomical landmarks in the case and hence cholangiography would not have changed the intraoperative surgical plan. Otherwise, we do perform cholangiograms in some cases.
Hence, do have a look at the video to get practical tips for safe cholecystectomy and also have a look at the Strasberg safe cholecystectomy culture summary that we will provide on our website as well You can go to the Facebook page here: https://www.facebook.com/edu.surg.14/
You can go to the website here:
A bit about the STEP BY STEP SURGERY SERIES OF EDUSURG:
This video series will help you understand the surgeries from various viewpoints. It will assist in
- Writing surgery questions in the exam
- Learning the port position, patient position as well as steps of surgery
- Answering the procedure questions in practical exams
- Multiple choice questions on surgical techniques
- Tips and tricks for SAFE SURGERY
So. let's have fun...
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Let's make surgery fun, factual, and free...