Basic laparoscopy: Cholecystectomy 08.10 Gallbladder removal Quiz

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Under construction 18 02 2008

Basic laparoscopy: Cholecystectomy 08.10 Gallbladder removal Quiz

1 How do you start the dissection of the gallbladder?

Elevate Hartmann's pouch.

Pull the fundus down.

Rotate the patient.

Grasp the clip on the gallbladder end of the cystic duct.

2 How do you free the gallbladder from the liver bed?

Methodically coagulate/cut tight strands of tissue.

Dissect out vessels running from the gallbladder bed.

Increase the upward pull on the fundus.

Elevate the liver.

3 On the diagram, click on the line you would choose to dissect the gallbladder.

At present, this question can only be fully displayed on the CD-ROM

version of the program.

4 If the gall bladder leaks on dissection, should you:

Close the defect in the gallbladder with the forceps and continue dissecting.

Aspirate the gallbladder through the perforation.

Apply an Endoloop.

Ignore the leakage.

5 If there is a bile leak from the gallbladder bed, would you:

Convert to an open operation.

Expect that it will close spontaneously.

Identify and coagulate the minor biliary vessel.

Apply local pressure.

6 If the gallbladder jams in the epigastric port, would you:

Aspirate the gallbladder through the epigastric port.

Widen the epigastric port.

Remove the stones from the gallbladder through the epigastric port.

Pull harder on the gallbladder.

7 When would you consider closing the fascia after removing a port?

When the opening was wider than 10mm.

For all ports.

In a fat patient.

If there was a leak from the gallbladder.

8 At what stage should you insert a suction drain?

After removing the gallbladder from the patient.

After examining the gallbladder bed.

After removing the subcostal port.

After cutting the cystic duct.

This is the last article in the Basic laparoscopy training program.

We hope you have benefitted from it.

We welcome your comments and contributions.

Michael Edwards and team.

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