The patient was met in the preoperative holding area, patient, consent, site and procedure to be performed confirmed. All questions answered. The patient was transported to the operating room and placed on the table in supine position. [A foley was placed]. [abx] was given prior to the start of the procedure. The patient was secured to the table and all boney areas padded. The abdomen was prepped and draped in the normal sterile fashion. A timeout was done and all were in agreement.
The abdomen was accessed via optical trocar in the left upper quadrant and insufflated. The area was inspected and there was no bleeding or visceral injury. 11 mm supra umbilical, 5 mm right lateral, 5 mm right upper quadrant trocars were placed under direct visualization.
The gallbladder was visualized and noted to be [appearance]. The gallbladder was retreated towards the patient’s right shoulder. Adheared stomach and fat were bluntly pushed away from the gallbladder. The hepatocystic triangle was dissected with blunt technique and hook cautery. The cystic duct and after were identified and skelatonized. The lower 1/3 of the gallbladder was dissected from the liver bed and the CVOS was achieved.
The cystic duct and arteries were clipped in triplicate and transected with scissors. The gallbladder was separated from the cystic plate with hook cautery. It was placed in a bag. The clips were noted to be in place. The liver bed was noted to be hemostatic.
The gallbladder was removed through the umbilical incision. The umbilical fascia was closed with 2-0 Vicryl and the Carter-Thomason device. An additional interrupted 2-0 Vircyl simple stitch was used.
The abdomen was desufflated. The skin incisions were closed with 4-0 Monocryl and dressed with derma bond. The patient was liberated from anesthesia, extubated and transported to the PACU in stable condition.
The attending surgeon was present throughout the entire procedure.
Service: GS (white)
Author: Garrett Skinner