胆囊切除术 - 无夹扣，Endoloops胆囊管

Cholecystectomy - Clipless, Endoloops on Cystic Duct

发布时间：2013-07-11

Video presents a case of a 63 years old woman with a history of 2 episodes of biliar pancreatitis, after the second pancreatitis, she was kept in the hospital to perform a eletive cholecystectomy.
The surgery started with the insertion of a 10mm trocar on the umbilicus and 3 x 5mm trocars (one in epigastric and 2 on hipocondrium), During the surgery, a gallbladder with lot of adhesions was found, after a meticulous adhesiolisys with monopolar hook, a anterograde dissection (starting from the medial portion of the body of the gallbladder, folowed by the detached of the fundus until the infundibulum was reached), than the pedicle was dissected using hook and maryland. The cystic duct and cystic artery were isolated, the cystic artery was cauterized with monopolar Hook, The cystic duct was ligated with 2 proximal and 1 distal endoloop (hand made - prolene 2.0), and the artery stump was ligated with another endoloop. than the cystic duct was cutted, aspirated, and the specimen was gloved. After hemostasis inspection, trocar removed under direct vision, the specimen was retrived through the umbilical incision.
Patient was discharged next day from the surgery with no symptons.

Surgical Crew: IgorTFerreira / CMG(Md) Algarve / GM(Md) Daniel Marzullo