1 / 8

TECHNICUE OF LAP. CHOLE

TECHNICUE OF LAP. CHOLE. BY. DR . AHMED KENSARAH. Technique of lap chole. Grasping forceps are pushing up the fundus of the gallbladder elevating the liver and stretching the gallbladder longitudinally

judith
Download Presentation

TECHNICUE OF LAP. CHOLE

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. TECHNICUE OF LAP. CHOLE BY. DR . AHMED KENSARAH

  2. Technique of lap chole Grasping forceps are pushing up the fundus of the gallbladder elevating the liver and stretching the gallbladder longitudinally Asecond instrument holds the hartmann’s pouch allowing a good visualization of triangle of calot.

  3. Technique of lap chole • This image shows a lateral retraction on the Hartmnn’s pouch, pulling the cystic duct and artery away from hepatic duct. • A disectoris passed through to isolate the cystic duct from the artery.

  4. Technique of lap chole • Once the cystic artery is isolated and cleaned its attachments, the cystic duct is dissected and clearly visualized by pushing backwards the cystic artery and forward the duct in one single manouver.

  5. Technique of lap chle • Upon completition of thedissection , clips are applied to the cystic artery and divided with scissors.

  6. Technique of lap chole • Now the cystic duct is doubly clipped and then transected with scissors. • Electrocautery or laser should not be used to avoid necrosis of tissue under the clips and possible post-operative bile leakage.

  7. Technique of lap chole • Dissection is performladdered through each side of the gallbldder dividing the peritoneal reflection. • The Hartmann’s pouch is pulled superiorly and medially to permit good field exposure while the gallbladder is being freed from the liver bed it can be removed .

More Related