Safe Laparoscopic cholecystectomy - critical view of safety - documentation - webinar part 1

Laparoscopic cholecystectomy is one of the most commonly performed surgical procedures in general surgical practice. As it is said, no cholecystectomy should be considered as simple as we can have variations in Anatomy, variations in the landmarks that are useful in the surgery as well as variation in the disease extent.

Because of this reason and associated morbidity and occasional mortality of biliary injury in this surgery, a culture of safety in laparoscopic cholecystectomy @Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) is being propagated for a long time.

This is the first video of the webinar on laparoscopic cholecystectomy and the management of biliary injuries where safety for patient and surgeon is discussed in laparoscopic cholecystectomy procedure.

This video explains Patient Safety where we need to take all precautions to avoid a biliary injury as well as missing incidental gallbladder cancer and as far as the surgeon safety is concerned, avoiding the injury, and proper consent and documentation to avoid medico-legal litigations.

The video begins with pre-operative considerations including disease factors, blood investigations, Anatomical variations in the biliary system as well as patient comorbidities.

The next and one of the most important points is consent in surgery and this has been explained in detail with the key point being mention of SOS open surgery and SOS subtotal cholecystectomy.

The third point is intraoperative consideration which is usually the only considered point in safe laparoscopic cholecystectomy. That is why this talk focuses on a comprehensive safety checklist not only on achieving critical view of safety.

The key intraoperative factor is a critical view of safety, identification of landmarks in surgery as well as knowing the bailout strategies when the critical view of safety cannot be achieved. The bailout strategies include subtotal cholecystectomy and conversion to open surgery.

After this is a discussion on the points to avoid missing gallbladder cancer and reducing the incidence of incidental gallbladder cancer in your cases. Examination of the specimen after retrieval in endo-bag is stressed upon.

The next important point discussed in this talk is documentation and this is important for surgeon safety. The key points to be documented are highlighted here. Thus, the talk provides a comprehensive safety checklist that should be followed for a safe laparoscopic cholecystectomy for both the patient and the surgeon.