Pravish Rai Sookha, MD, PhD. Clinique du Nord
Introduction: The limit of minimally invasive surgery is challenged constantly in todays world. After an era where conventional laparoscopic surgery was a challenge, today we are facing the same challenge with SILS.
Methods and Procedures: After training from Pelican hospital Romania under the guidance of Prof Maghiar I started performing SILS cholecystectomy in our hospital from 2012. We standardized our method in our hospital to make it easier for other colleagues to start practicing SILS, as the demand for SILS is increasing constantly. We use 2 ports through the umbilicus and 3 suspensory sutures.
Step 1: Opening the umbilicus
Step 2: Introducing the optic port
Step 3: Pneumoperitoneum and brief exploratory laparoscopy
Step 4: Introducing 2nd port
Step 5: Introduce a grasping forcep through 2nd port and check the gallbladder and other organs
Step 6: Table position- Anti-Trendelenburg with left tilt
Step 7: 1st suspensory suture- midclavicular line and between last 2 ribs
Step 8: 2nd suture medial clavicular line 10cms above umbilicus
Step 9: 3rd suture lateral clavicular line at umbilical level
Step 10: Visualize the infundibulum
Step 11: Dissect cystic duct and artery
Step 12: Achieve Strasberg critical view of safety
Step 13: Clip duct and artery
Step 14: Dissect Gallbladder from liver while retracting 2nd and 3rd sutures
Step 15: Before finishing the Gallbladder dissection- clean and verify hemostasis
Step 16: Complete Gallbladder dissection
Step 17: Remove Gallbladder
Step 18: Close umbilicus
Conclusion: Standardizing the method has proven it easier to be accepted by surgeons, as well as decreasing conversions to conventional laparoscopy
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80169
Program Number: P096
Presentation Session: Poster (Non CME)
Presentation Type: Poster