Gallbladder: Laparoscopic Cholecystectomy

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BOARD 1
1. Normal anatomy: orientation view
2. Normal anatomy: detail of stomach and duodenum
3. Detail: surgical view

BOARD 2
1. Female: trocar placement for laparoscopic cholecystectomy

BOARD 3
1. Trocar placement for laparoscopic cholecystectomy

BOARD 4
1. Male: trocar placement for laparoscopic cholecystectomy

BOARD 5
1. Male: trocar placement for laparoscopic cholecystectomy

BOARD 6
1. Operative suite during lap chole

BOARD 7
1. Sagittal view: insertion of Veress needle through umbilicus
2. Insufflation of abdomen

BOARD 8
1. Anterior view w/ port
2. View through camera w/ extensive adhesions
3. Side cutaway view w/ extensive adhesions

BOARD 9
1. trocar placement
2. Laparoscopic views
3-6. Cholecystectomy

BOARD 10
1. View through camera without adhesions
2. View through camera with adhesions

BOARD 11
1. Anterior view: trocar 1 in umbilicus
2. Detail: laparoscopic view of adhesions
3. Sagittal view: trocar 1 in abdomen with adhesions

BOARD 12
1. Anterior view: trocars in abdomen
2. Detail: laparoscopic view of adhesions
3. Sagittal view: trocars in abdomen with adhesions

BOARD 13
1. Anterior view: trocars in abdomen
2. Detail: laparoscopic view of adhesions
3. Sagittal view: trocar in abdomen with adhesions

BOARD 14
1. Laparoscopic port placement
2. Intra-op photo examples
3. Surgical view: fatty tissue covering ducts
4. Surgical view: hidden ducts under fatty tissue in normal anatomy

BOARD 15
1. Surgical view: fatty tissue covering ducts

BOARD 16
1. Surgical view: variant anatomy hidden by fatty inflammatory tissue

BOARD 17
1. Surgical view: lateral traction, dissection of cystic duct
2. Detail view: lateral traction, dissection of cystic duct

BOARD 18
1. Surgical view: cystic artery dissection
2. Detail view: cystic artery dissection

BOARD 19
1. Surgical view: cystic artery dissection
2. Detail view: cystic artery dissection

BOARD 20
1. Surgical view: cystic artery clipped
2. Detail view: cystic artery clipped

BOARD 21
1. Anterior view: instruments placed through multiple ports in abdomen
2. Normal anatomy of gallbladder and ducts
3. Clipping of cystic duct and removal of gallbladder
4. Clipping of cystic duct with injury to hepatic duct by clip

BOARD 22
1. Anterior view: instruments placed through multiple ports in abdomen
2. Detail: Pre-operative condition
3. Detail: mobilization and division of cystic duct
4. Surgical procedure / common duct clamped and cut

BOARD 23
1. Clipping of gallbladder and cystic artery
2. Clipping of gallbladder and cystic artery with common bile duct clipped

BOARD 24
1-3. Variations of duct anatomy during cholecystectomy

BOARD 25
1. Anatomy of gallbladder and ducts with area of cholecystectomy and small perforation of duodenum
2. Triangle of Calot

BOARD 26
1. Dissection of ducts

BOARD 27
1. Superior traction of gallbladder
2. Superior and lateral traction of gallbladder

BOARD 28
1. Surgical anatomy during cholecystectomy: superior traction

BOARD 29
1. Surgical anatomy during cholecystectomy: superior and lateral traction

BOARD 30
1. Surgical anatomy during cholecystectomy: dissection of cystic duct

BOARD 31
1. Surgical anatomy during cholecystectomy: clipping of cystic duct

BOARD 32
1. Normal anatomy of gallbladder
2. Normal surgical procedure / clamping and cutting cystic duct
3. Abnormal cystic duct / gallbladder with adhesion to common duct
4. Surgical procedure / common duct clamped and cut

BOARD 33
1. Orientation view
2. Vasculature of the gallbladder

BOARD 34
1. Hepaticoduodenal ligament
2. Example of case specific laparoscopic view of common bile duct

BOARD 35
1. Surgical view
2. Scar tissue obliterates cystic duct
3. Pulling of the gallbladder distorts ducts
4. Ducts clamped and cut

BOARD 36
1. Dissection line
2. Duct cut with clamps
3. Diagram of surgical procedure

BOARD 37
1. Laparoscopic cholecystectomy: critical view of safety: normal ducts
2. Laparoscopic cholecystectomy: critical view of safety: short cystic duct

BOARD 38
1. Illustration of photo taken during cholecystectomy

BOARD 39
1. Illustration of photo taken during cholecystectomy

BOARD 40
1. Illustration of photo taken during cholecystectomy

BOARD 41
1. Illustration of photo taken during cholecystectomy

BOARD 42
1. Medial dissection
2. Critical view technique

BOARD 43
1. Lateral dissection
2. Infundibular technique

BOARD 44
1. Detail of surgical exposure
2-3. clips placed