Abstract

Research Article

Laparoscopic Cholecystectomy: Challenges faced by beginners our perspective

Kunal Chowdhary, Gurinder Kaur, Kapil Sindhu, Muzzafar Zaman*, Aliya Shah, Rohit Dang, Ashish Kumar, Jose John Maiakal and Ashutosh Bawa

Published: 23 August, 2018 | Volume 2 - Issue 2 | Pages: 018-024

Background: Laparoscopic cholecystectomy is gold standard and most widely performed surgery for gallstone disease all over the world. Surgeons entering into the field of laparoscopic surgery for the first time faces challenges that are different from those with experienced hands. We in this study tried to enumerate the various such challenges and also recommend few steps to counter them.

Aims & Objectives: To study the challenges faced by new surgeons in laparoscopic cholecystectomy and recommendations to reduce them.

Material & Methods: This study was carried out in a medical college in the department of General and Minimal Access surgery. In this retrospective study, ten general surgeons working as senior residents in in this medical college over a period of 3 years having never performed laparoscopic surgery in past were included.

Results: A total of 50 cases, five operated by each surgeon with minimal assistance by senior surgeon in few cases. Operative time varied from 90 to 120 minutes. The various technical challenges faced by the new surgeon were in the Creation of Pneumoperitoneum, Creation of second port (epigastric port 10mm), Gallbladder Retraction and Dissection at calot’s triangle, Dissection at gallbladder bed and Removal of the gallbladder from epigastric port.it has been observed that following various simple steps will abate these technical difficulties for these beginners while doing laparoscopic cholecystectomy.

Conclusion: Laparoscopic cholecystectomy is the most commonly performed minimal access surgical procedure nowadays and almost all the new surgeons enter the world of laparoscopic surgery via this surgery. Knowing and following the above recommendations will help them abate the technical challenges generally faced during the initial phase in the laparoscopic field.

Read Full Article HTML DOI: 10.29328/journal.ascr.1001018 Cite this Article Read Full Article PDF

Keywords:

Laparoscopic Cholecystectomy; Beginners; Technical Challenges

References

  1. Hurley V, Brownlee S. Cholecystectomy in California: A Close-Up of Geographic Variation. California Healthcare Foundation. 2011.
  2. Mac Fadyen BV, Jr Vecchio R, Ricardo AE, Mathis CR. Bile duct injury after laparoscopic cholecystectomy - The United States experience. Surgical Endoscopy. 1998; 12: 315-321. Ref.: https://tinyurl.com/ycwrjxqn
  3. Keus F, de Jong JAF, Gooszen HG, van Laarhoven CJHM. Laparoscopic versus open Cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane Database of Systematic Reviews 2006. Ref.: https://tinyurl.com/y9xhxarc
  4. Buddingh KT, Weersma RK, Savenije RA, van Dam GM, Nieuwenhuijs VB. Lower rate of major bile duct injury and increased intraoperative management of common bile duct stones after implementation of routine intraoperative cholangiography. J Am Coll Surg 2011; 213: 267-274. Ref.: https://tinyurl.com/y94qy84n
  5. Kern KA. Malpractice litigation involving laparoscopic cholecystectomy. Cost, cause, and consequences. Arch Surg. 1997; 132: 392-397. Ref.: https://tinyurl.com/yapdvljk
  6. Flum DR, Flowers C, Veenstra DL. A cost-effectiveness analysis of intraoperative Cholangiography in the prevention of bile duct injury during laparoscopic cholecystectomy. J Am Coll Surg. 2003; 196: 385-393. Ref.: https://tinyurl.com/yasdecak
  7. Lal P, Singh L, Agarwal PN, Kant R. Open Port Placement of the First Laparoscopic Port: A Safe Technique. JSLS. 2004; 8: 364-366. Ref.: https://tinyurl.com/y8n55af9
  8. Haribhakti SP, Mistry JH. Techniques of laparoscopic cholecystectomy: Nomenclature and selection. J Minim Access Surg. 2015; 11: 113-118. Ref.: https://tinyurl.com/y7u98gcp
  9. Abdullah A Albarrak, Sami Khairy, Alzahrani Mohammed Ahmed. Laparoscopic Cholecystectomy for Acute Calcular Cholecystitis in a Patient with Ventriculoperitoneal Shunt: A Case Report and Literature Review. Case Rep Surg. 2015. Ref.: https://tinyurl.com/y8yjk6xl
  10. Vettoretto N, Saronni C, Harbi A, Balestra L, Taglietti L, et al. Critical View of Safety During Laparoscopic Cholecystectomy. JSLS. 2011; 15: 322-325. Ref.: https://tinyurl.com/ybkmpkmj
  11. Sorrentino L, Serra F, Cabry F, Gelmini R. Dome down Laparoscopic Cholecystectomy: Our Experience and the State of Art. Annals of Emergency Surgery. 2017; 2: 1022. Ref.: https://tinyurl.com/ybw5e5ua
  12. Honda G, Iwanaga T, Kurata M. Dissection of the gallbladder from the liver bed during laparoscopic cholecystectomy for acute or subacute cholecystitis. J Hepatobiliary Pancreat Surg. 2008; 15: 293-296. Ref.: https://tinyurl.com/y7ruppyo
  13. Majid MH, Meshkat B, Kohar H, El Masry S. Specimen retrieval during elective laparoscopic cholecystectomy: is it safe not to use a retrieval bag? BMC Surgery. 2016; 16: 64. Ref.: https://tinyurl.com/yatrxnyh

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