Experimental studies of transgastric gallbladder surgery: cholecystectomy and cholecystogastric anastomosis (videos) Per-Ola Park, MD, Maria Bergström,

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Presentation transcript:

Experimental studies of transgastric gallbladder surgery: cholecystectomy and cholecystogastric anastomosis (videos) Per-Ola Park, MD, Maria Bergström, MD, Keiichi Ikeda, MD, Annette Fritscher-Ravens, MD, Paul Swain, MD Gastrointestinal Endoscopy Volume 61, Issue 4, Pages 601-606 (April 2005) DOI: 10.1016/S0016-5107(04)02774-9 Copyright © 2005 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 A, Endoscopic view of second endoscope (guidewire in accessory channel) passing through stomach wall into peritoneal cavity parallel to falciform ligament. Insertion tube of first endoscope is seen at top, with small intestine above and colon to right and left. B, Endoscopic view of exposed gallbladder with grasping forceps applied to body to improve exposure. A snare grasping fundus of gallbladder (curving toward diaphragm) is ineffective in pushing it upward to improve exposure. Gastrointestinal Endoscopy 2005 61, 601-606DOI: (10.1016/S0016-5107(04)02774-9) Copyright © 2005 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 A, Endoscopic view of second endoscope (guidewire in accessory channel) passing through stomach wall into peritoneal cavity parallel to falciform ligament. Insertion tube of first endoscope is seen at top, with small intestine above and colon to right and left. B, Endoscopic view of exposed gallbladder with grasping forceps applied to body to improve exposure. A snare grasping fundus of gallbladder (curving toward diaphragm) is ineffective in pushing it upward to improve exposure. Gastrointestinal Endoscopy 2005 61, 601-606DOI: (10.1016/S0016-5107(04)02774-9) Copyright © 2005 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 2 A, Endoscopic view showing cystic duct grasped with forceps (yellow sheath) and attachments of gallbladder to liver being severed with a needle knife. Clips have been applied to cystic duct and artery. B, Endoscopic view showing last attachment of gallbladder to liver being severed with needle-knife. Grasping forceps are holding neck of gallbladder. Gastrointestinal Endoscopy 2005 61, 601-606DOI: (10.1016/S0016-5107(04)02774-9) Copyright © 2005 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 2 A, Endoscopic view showing cystic duct grasped with forceps (yellow sheath) and attachments of gallbladder to liver being severed with a needle knife. Clips have been applied to cystic duct and artery. B, Endoscopic view showing last attachment of gallbladder to liver being severed with needle-knife. Grasping forceps are holding neck of gallbladder. Gastrointestinal Endoscopy 2005 61, 601-606DOI: (10.1016/S0016-5107(04)02774-9) Copyright © 2005 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 3 A, Gallbladder bed after transgastric removal of gallbladder; a clip is present on cystic duct and artery. B, Gallbladder after removal. Gastrointestinal Endoscopy 2005 61, 601-606DOI: (10.1016/S0016-5107(04)02774-9) Copyright © 2005 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 3 A, Gallbladder bed after transgastric removal of gallbladder; a clip is present on cystic duct and artery. B, Gallbladder after removal. Gastrointestinal Endoscopy 2005 61, 601-606DOI: (10.1016/S0016-5107(04)02774-9) Copyright © 2005 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 4 Endoscopic view of gallbladder being pulled through stomach wall to form an anastomosis. Gastrointestinal Endoscopy 2005 61, 601-606DOI: (10.1016/S0016-5107(04)02774-9) Copyright © 2005 American Society for Gastrointestinal Endoscopy Terms and Conditions