Patient was met in the preoperative holding area. Informed consent was confirmed. All questions answered. Patient was transported to the operating room and placed supine on the table. Bony areas are padded and the patient was secured with straps. Sequential compression device devices were applied to the calves. General anesthesia was induced without issue and the patient was intubated successfully. Preoperative antibiotics were given. The patient was prepped and draped in the normal sterile fashion. Timeout was done and all were in agreement.
Access the abdomen was gained via open approach in the supraumbilical area and a 10 mm Hassan trocar was placed. The abdomen was insufflated to 15 mmHg and there was noted to be no injury to the bowel. Three additional 5 ports replaced triangle in the gallbladder under direct vision without visceral injury. The gallbladder is retracted towards the right shoulder. Dissection proceeded with hook cautery to free the lower one third of the gallbladder fossa and clear the hepatocycstic triangle of tissue and obtained the critical view of safety. The cystic artery was transected with hooky during this and noted to be hemostatic.
The cystic duct was triple clipped on the stay side and transected sharply. The cystic artery was clipped and transected sharply. The gallbladder was removed from the fossa. [bile spillage?] The gallbladder fossa was gonna be hemostatic after this. The clips were noted to be in a good position. The gallbladder is placed in a bag and retrieved through the umbilical incision. The abdomen was completely dessuflated.
The umbilical incision was close primarily with size zero Vicryl suture in a figure-of-eight fashion. [volume] cc local anesthetic was injected throughout. The skin was closed with size 4-0 Monocryl and dressed with Dermabond. Final counts were correct. The patient was liberated from anesthesia and transported to the PACU in stable condition. Dr. Brewer was present the entire case.
Service: GS (EC-B)
Author: Garrett Skinner