[Videolaparoscopic cholecystectomy. Experience, evolution, and comparison of techniques]

Area of Science:

• Gastroenterology
• Minimally Invasive Surgery
• Surgical Innovation

Background:

• Gallbladder calculosis is a common condition requiring surgical intervention.
• Laparoscopic cholecystectomy has become the standard treatment.
• Complex cases present challenges to the standard laparoscopic approach.

Purpose of the Study:

• To review and highlight innovations in laparoscopic cholecystectomy.
• To discuss advancements that extend the technique to complicated gallbladder disease.
• To evaluate the impact of these innovations on patient outcomes.

Main Methods:

• Literature review focusing on innovations in laparoscopic cholecystectomy.
• Analysis of specific technical advancements, including specialized equipment and suturing techniques.
• Discussion of adjunctive diagnostic and therapeutic procedures like intraoperative cholangiography.

Main Results:

• A 30-degree oblique vision laparoscope aids in precise dissection and identification of the common bile duct (CBD).
• Laparoscopic suturing of the cystic duct and artery offers advantages over metal clips.
• Intraoperative cholangiography effectively identifies common bile duct stones and anatomical variations.
• Management of choledocholithiasis during laparoscopic cholecystectomy is feasible.

Conclusions:

• Innovations in laparoscopic cholecystectomy enhance safety and efficacy, particularly in complex gallbladder disease.
• Advanced visualization, secure ligation techniques, and intraoperative imaging improve surgical precision.
• These advancements facilitate the extension of laparoscopic cholecystectomy to a wider range of patients.