Patient supine under SAB/CLEA/GA
Asepsis and antisepsis technique
Sterile drapes placed
Incision made carried from skin through
subcutaneous tissue
Midline – Fascia cut and opened through linea alba
Kocher’s (Right Subcostal) – Anterior rectus sheath cut and opened
Right belly of Rectus muscle cut
Posterior Rectus sheath cut and opened
Peritoneum cut and opened
Exploration of entire abdomen carried out
Intra-operative findings noted
Retractors applied accordingly
Gallbladder identified and clamped with a Kelly
at the ampulla applying traction
Triangle of Calot dissected, cutting the
peritoneum that covers the area; Cystic duct identified, isolated and a
temporary silk 4-0 ligature applied.
Intra-operative cholangiogram done, findings
noted
Cystic artery identified, isolated, ligated and
divided
Gallbladder deperitonealization done and
dissected from the liver bed using electrocautery
Cystic duct divided and doubly ligated
Common bile duct palpated
Peritoneal lavage
Hemostasis
Complete sponge and instrument count
Closure layer by layer
Peritoneum and Fascia – Vicryl 0 continuous
Subcutaneous layer – chromic 2-0 inverted T-sutures
Skin – silk 3-0 interrupted sutures
Betadine paint
Dry sterile dressing placed
