Laparoscopic

Choledocotomy

R. K. Mishra

World Laparoscopy Hospital Advanced Laparoscopic Surgery

 Biliary Anatomy

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Transcystic vs
Transcholedocal approach

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Operating room set-up

Reverse
Trendelenberg

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Operating room set-up

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Port Position

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Choledocoscope

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Laparoscopic Ultrasound

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Dormia Basket

•Dormia Basket is used to extract

Stone
•It should be of less than 1 mm
diameter in thickness

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Dilators

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Exposure

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Dissection of Callots Triangle

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Clipping of Cystic Duct

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Secure Cystic artery

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Intraoperative Cholangiogram

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Intraoperative Cholangiogram

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Choledocoscopy

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Opening of Anterior
Peritoneum of CBD

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Choledocotomy

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Extraction of stone

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Extraction of stone by suction

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Extraction of stone by milking

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Extraction of stone by catheter

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Choledocolithotomy

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Confirmation of stone
clearance

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Extraction of stone by Dormia

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Insertion of T tube

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Fixation of T tube

World Laparoscopy Hospital Essentials of Laparoscopic Surgery

 Cholecystectomy

After finishing Choledocotomy a retrograde

Cholecystectomy is performed
World Laparoscopy Hospital Essentials of Laparoscopic Surgery
 Thank
You

Prof. Sir Alfred Cuschieri Giving Lecture to

Dr. R. K. Mishra at Ninewells Hospital U.K.

World Laparoscopy Hospital Essentials of Laparoscopic Surgery