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, all boney areas padded, and secured to the table with straps. [abx] was given prior to the start of the procedure. 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 supraumbilical cutdown and placement of 12 mm Hassan trocar. The abdomen was insufflated to 15 mmHg. The area was inspected and there was no bleeding or visceral injury. Three additional 5 mm ports were placed to triangulate the gallbladder.
The gallbladder was visualized and noted to be [appearance]. It was retreated towards the patient’s right shoulder. [Adhesions]. The hepatocystic triangle was dissected with blunt technique and hook cautery until we achieved the critical view of safety noting two structures entering the gallbladder, the hepatocystic triangle clear of fatty and fibrous tissue and the lower one third of the cystic plate dissected.
The cystic duct and artery were clipped with metal 5 mm Hemolock clips, three on the duct and two on the artery 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 supraumbilical incision. This fascia was closed with size 0 Vicryl in a figure-of-eight fashion. A total of [volume] cc of local anesthetic was injected to this fascial closure as well as the remaining incisions.
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.
Dr. [surgeon] was present throughout the entire procedure.
Service: GS (green)
Author: Garrett Skinner