Rouviere's sulcus as a helpful anatomical landmark for safe laparoscopic cholecystectomy

Area of Science:

• Surgical Anatomy
• Hepatobiliary Surgery
• Minimally Invasive Surgery

Background:

• Rouviere's sulcus (RS) is an anatomical landmark on the liver's inferior surface.
• Its relationship with the common bile duct (CBD) is crucial for surgical procedures.
• Understanding RS morphology is key for enhancing surgical safety.

Purpose of the Study:

• To determine the frequency, morphology, dimensions, and subtypes of RS.
• To assess the utility of RS as a landmark for safe laparoscopic cholecystectomy.
• To correlate RS characteristics with surgical outcomes.

Main Methods:

• Prospective observational study over six months (July-December 2021).
• Inclusion of 192 adult patients undergoing laparoscopic cholecystectomy for symptomatic gallstones.
• Analysis of RS presence, type, orientation, and level relative to critical structures.

Main Results:

• RS was identified in 87.5% of patients.
• Common types included deep open (75%) and deep closed (22.0%).
• Transverse orientation was most frequent (74.4%), with RS typically at the same level as the critical view of safety (97.02%).

Conclusions:

• Rouviere's sulcus is a frequent anatomical landmark.
• Its presence and characteristics predict a safe laparoscopic cholecystectomy.
• RS serves as a reliable guide, locating the CBD inferiorly and cystic structures superiorly.