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History notes
BLUMGART, pg 6 ISBN 1455746061 Before cholecystectomy was developed, surgical therapy for biliary colic was limited to cholecystostomy, or gallstone removal.[B] Based on studies in dogs from the 17th century demonstrated that the gallbladder was a nonessential organ and contemporary medical opnion that gallstones formed in the gallbladder, Karl Langenbuch began developing the technique for cholecystectomy in the late 19th centry.[B] On July 15, 1882 Langenbuch performed the first successful cholecystectomy at the Lazarus hospital in Berlin.[B] Although the technique was initially controversial, by the end of the 19th century, cholecystectomy had become preferred over cholecystostomy for treatment of biliary colic due to a lower rate of mortality.[B]

Mouret performed the first video laparoscopy

PAGE, pg 83 ISBN 144084478X

POLYCHRONIDIS Almost a century after the development of open cholecystectomy, laparascopic techniques began being widely adopted for procedures in gynecology.[P] Erich Muhe was inspired by the first laparascopic appendectomy, performed by gynecologis Kurt Semm in 1980, to develop a technique for laparascopic cholecystectomy.[P] On Sept 12, 1985, Muhe performed the first laparascopic cholecystectomy.[P] His work was largely ignored due to strong resistance from the German academic surgical establishment and difficulty disseminating his work in English.[P] His pioneering work was not fully recognized by the German Surgical Society Congress until 1992.[P]

Philippe Mouret first performed laparascopic cholecystectomy on March 17, 1987 in Lyon. His technique was rapidly adopted and improved in France, then introduced worldwide over the next three years. The popularity of the laparascopic approach was largely driven by patient request.

LITYNSKI Muhe presented his technique to the Congress of the German Surgical Society in 1986, claiming reduced postoperative and shorter hospitalization.[L] His work was met with stong resistance by the German acadamic surgical establishment and referred to as "Mickey Mouse surgery."[L]

STERN https://www.generalsurgerynews.com/In-the-News/Article/06-13/The-first-Lap-Chole-in-Europe-A-%E2%80%98Criminal%E2%80%99-Is-Vindicated/23368/ses=ogst Muhe's work was further disparaged in 1987, when he was charged with manslaughter because a postoperative patient death was mistakenly attributed to his innovative technique, in spite of almost 100 prior successful laparoscopic cholecystectomies.[St] He was eventually exonerated in 1990 after further investigation.[St]

SCHWARTZ's ISBN 9780071796743 Laparascopic cholecystectomy became preferred to open cholecystectomy and noninvasive measures for treatment of gallstones. [Sch] Today, laparascopic cholecystectomy is the standard treatement for symptomatic gallstones. [Sch]

Procedure notes
Cholecystectomy is most commonly performed using a laparascopic approach but can also be done using alternative minimally invasive approaches or an open approach. During the procedure the gallbladder, cystic duct and cystic artery are identified. Then, they are dissected away from the liver. The cystic duct and cystic artery or ligated, or clamped, then divided, or cut. Finally, the gallbladder is removed with the cystic duct and cystic artery.

SCHWARTZ Preoperative preparation Before surgery, a CBC and LFTs are obtained. DVT prophylaxis is also initiated. Gas may be removed from the stomach with an orogastric or nasogastric tube. A Foley catheter may be used to empty the patient's bladder.

Lap An incision is made above the navel. The abdominal cavity is filled with carbon dioxide. A camera is incerted through 1) Trocars are placed 2) Visualization of the hepatocystic triangle (triangle of Calot) 3) Dissection of gallbladder, cystic duct, and cystic artery 4) Ligation and division of duct and artery 5)

Evaluation intraop cholangiograph lap ultrasound

OVERBY 20706739 Preoperative management Use of prophylactic antibiotics is controversial; however, a dose may be given prior to surgery to prevent infection in certain high risk patients [O].

Postoperative management Patients with uncomplicated, elective surgery may be discharged on the same day as procedure if pain and nausea are well-controlled [O].

INGRAHAM 20670855 As of 2008, 90% of cholecystectomies in the United States were done laparoscopically [I]

NOTES is a technique that uses natural orifices for access to the abdominal cavity instead instead of skin incisions. This offers the potential to eliminate visible scars. Since 2007, NOTES cholecystectomy has been performed via transgastric and transvaginal routes anecdotally. Technical limitations, including the risk of gastrointestinal leak from trangastric surgery and difficulty visualizing the abdominal cavity, currently limit clinical adoption of NOTES for cholecystecomy