Which incision is used for the classic open cholecystectomy procedure?

Which incision is used for the classic open cholecystectomy procedure?

In open cholecystectomy, a surgical incision of around 8 to 12 cm is made below the edge of the right rib cage and the gallbladder is removed through this large opening, typically using electrocautery.

What sutures are used in cholecystectomy?

The fascia is closed at the umbilical port by using the two U stitches placed at the beginning of the procedure. All of the skin incisions are closed with 4-0 absorbable monofilament suture, followed by cyanoacrylate tissue adhesive. (See the image below.) Laparoscopic cholecystectomy.

What are the indications for laparoscopic cholecystectomy?

Indications

• Cholecystitis (Acute/Chronic)
• Symptomatic cholelithiasis.
• Biliary dyskinesia- hypofucntion or hyperfunction.
• Acalculous cholecystitis.
• Gallstone pancreatitis.
• Gallbladder masses/polyps.

What is now the most common indication to perform open cholecystectomy?

Indications for cholecystectomy, either open or laparoscopic, are usually related to symptomatic gallstones or complications related to gallstones. The most common of these indications are the following: Biliary colic. Biliary pancreatitis.

What is an oblique incision?

Oblique incisions are of two types: Gridiron incision: It is a muscle-splitting oblique incision made at the right lower part of the abdomen. It is used for appendectomy. Rockey-Davis incision: It is a crossover incision made at the right lower part of the abdomen. It is used for appendectomy.

What tool is used for open cholecystectomy?

Equipment for open cholecystectomy includes instruments common to a major instrument tray, as follows: Kelly clamps, Kocher forceps, needle holders, scissors, clips, suctions, knife/knife handles, forceps, retractors, right-angle clamps, Kitner dissectors, and electrosurgical devices should be assembled.

What sutures are absorbable?

Types of absorbable sutures

• Gut. This natural monofilament suture is used for repairing internal soft tissue wounds or lacerations.
• Polydioxanone (PDS).
• Poliglecaprone (MONOCRYL).
• Polyglactin (Vicryl).

What is fundus first cholecystectomy?

It is concluded that in laparoscopic cholecystectomy the fundus first technique, replacing a conventional technique, can be effectively introduced. The change into the fundus first technique is associated with lower rates of common bile duct injury. Clipless closure of the cystic duct increases the rate of leakage.

Who is a candidate for laparoscopic cholecystectomy?

As stated in the NIH report “most patients with symptomatic gallstones are candidates for laparoscopic cholecystectomy, if they are able to tolerate general anesthesia and have no serious cardiopulmonary diseases or other co-morbid conditions that preclude operation”.

Why do I have 4 incisions for gallbladder surgery?

2 and 3 – These are smaller incisions for instruments that hold and move the gallbladder. 4 This incision is for an instrument that removes the gallbladder. Your incisions (cuts) may not be in the same places.

What is the difference between open and laparoscopic cholecystectomy?

Laparoscopic cholecystectomy—The gallbladder is removed with instruments placed into small incisions in the abdomen. Open cholecystectomy—The gallbladder is removed through an incision on the right side under the rib cage.

When is Paramedian incision used?

The paramedian incision should be used for major elective laparotomies. The use of the midline incision should be restricted to operations in which unlimited access to the abdominal cavity is useful or necessary.

What are the indications for cholecystectomy?

What are the indications for cholecystectomy? Cholecystectomy is indicated in the presence of gallbladder trauma, gallbladder cancer, acute cholecystitis, and other complications of gallstones. More controversial are the indications for elective cholecystectomy.

When is laparoscopic cholecystectomy indicated for the treatment of gallstone disease?

Symptomatic gallstone disease. Biliary colic with sonographically identifiable stones is the most common indication for elective laparoscopic cholecystectomy. [ 8, 12] Acute cholecystitis, if diagnosed within 72 hours after symptom onset, can and usually should be treated laparoscopically.

What are the possible complications of laparoscopic cholecystectomy?

Litigation is much more common after laparoscopic cholecystectomy than after open cholecystectomy, for two apparent reasons. First, bile duct injuries are more common with laparoscopic cholecystectomy; second, missed intraoperative injuries may be more common in laparoscopic cholecystectomy cases.

What are the contraindications to laparoscopic surgery for cholecystitis?

Cholecystenteric fistula does not represent an absolute contraindication to laparoscopic surgery, though it does necessitate careful visualization of the anatomy and good laparoscopic suturing skills. [ 22] A substantial proportion of patients with acalculous cholecystitis are too ill to undergo surgery.